Dr. med. Dirk Manski

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Kidney Infarction

Definition of Renal Artery Embolism and Kidney Infarction

Renal artery embolism leads to a sudden interruption of blood flow in the renal artery or their main segmental branches and to ischemic kidney infarction. A hemorrhagic renal infarction can be the result from a renal vein thrombosis.

Etiology (Causes) of Kidney Infarction

Signs and Symptoms

Diagnostic Work-Up


Signs for kidney infarction are proteinuria, microhematuria or hematuria.

Laboratory tests:

Signs for kidney infarction are an increase in GOT, LDH, CK (intracellular enzymes indicating necrosis) and creatinine (if significant renal tissue is affected).


Doppler ultrasonography of the kidney can quickly confirm the diagnosis in kidney infarction.

Abdominal CT:

Easy diagnosis in post contrast images with wedge-shaped areas without contrast enhancement [fig. partial renal infarction]. The cortical rim sign is seen in 50% of the patients after several hours or days of infarction: a thin rim of cortex enhances due to collateral capsular perfusion.

fig. computed tomography of a left-sided partial renal infarction

Computed tomography of a left-sided partial renal infarction. Additional finding: a partial splenic infarction can be seen. With kind permission of Prof. Dr. K. Bohndorf, Augsburg.

Digital subtraction angiography (DSA):

Gold standard for diagnosis of acute vascular occlusion with the option for invasive treatment..

Treatment of Kidney Infarction

Conservative Treatment of Kidney Infarction:

Cornerstones of conservative treatment are analgesics, regulation of blood pressure and systemic heparinization. A thrombolytic therapy should be considered; the decision depends on the extent of infarction and the remaining renal function.

PTA or Surgical Therapy:

Percutaneous transluminal angioplasty or vascular surgery are indicated for patients with bilateral embolism or infarction of a solitary kidney, if diagnosis is made in time. The time window for successful interventions is unclear, interventions have to be done as an emergency. Please see anatomic or extra-anatomic bypass surgery ( treatment of renal artery stenosis).

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