Renal infarction: Difference between revisions

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==Differential Diagnosis==
==Differential Diagnosis==
*[[Mesenteric ischemia]]
*Lower lobe [[pneumonia]]
{{Flank pain DDX}}
{{Flank pain DDX}}



Revision as of 12:24, 23 November 2017

Background

  • Low ED incidence, approximately 1 per 90 to 100, 000 visits a year
  • Diagnosis frequently missed due to mimicking symptoms similar to other more frequent complaints such as pyelonephritis and nephrolithiasis
  • Caused by interruption of blood supply to kidney

Major causes

  • Cardioembolic disease
  • Renal artery injury
  • Hypercoagulable state
  • Dissection
  • Vasculitis

Clinical Features

Differential Diagnosis

Flank Pain

Evaluation

Laboratory

  • CBC with differential, CMP, LDH, urinalysis, urine culture
  • EKG- to evaluate for arrhythmia

Imaging:[1]

  • CT with IV contrast (preferred study)
  • Renal ultrasound - less senstive
  • MRI with gadolinium (contraindicated with severe renal impairment due to risk of nephrogenic systemic fibrosis)
  • Radioisotope scan - not commonly used

Management

Disposition

See Also

References

  1. Decoste R, Himmelman JG, Grantmyre J. Acute renal infarct without apparent cause: A case report and review of the literature. Canadian Urological Association Journal. 2015;9(3-4):E237-E239. doi:10.5489/cuaj.2466.