What is renal infarction? Causes, symptoms, and treatment tips

By: Mohan Garikiparithi | Bladder | Friday, May 12, 2017 - 02:00 PM

renal infarctionRenal infarction occurs when the blood supply to the kidney becomes disrupted or compromised and is often a sign of systemic illness. There are many causes of decreased blood supply to the kidney, and when observed, it should be investigated right away because proper kidney function is vital for survival. It can result from a blood clot or embolus arising from a distant location, or a thrombus limiting blood supply of the renal artery. Medications are available for these causes but are often time dependent, as delayed treatment can lead to significant kidney damage.

Renal infarction definition

A renal infarct is caused by a reduction of flow to one or both kidneys and can be caused by a blockage of the blood vessel leading to the organ. However, a direct blockage of blood is not the only way for infarction to occur, as in states where blood oxygenation is poor or in cases of congestive heart failure, the structures that are responsible for blood supply may be compromised.

Any cause of kidney injury leading to cell death may result in hematuria—blood in the urine. This is not seen by the naked eye initially, as microscopic levels may be present first. Injury to the kidney may also result in flank pain—pain that is located on the lower back.

Renal infarction causes and symptoms

The majority of renal infarctions occur due to a thromboembolic event, or clots. This phenomenon can occur in a multitude of ways, from disorders in clotting mechanisms to physical trauma leading to clot development. The following are some of the causes of renal infarction:

Due to obstruction of kidney blood flow:

Low cardiac output states leading to low kidney blood supply:

  • Congestive heart disease
  • Hypotension
  • Cardiac surgeries

Symptoms experienced during an issue of renal infarction may be non-specific and is therefore diagnosed later than it should be. Renal infarct may be the product of another underlying disease, further confounding the presentation. But there are a couple of specific kidney-related symptoms that are as follows:

  • Epigastric pain: Mostly observed over the epigastric dermatome and often radiates to the lower back either on the right or left side depending on the side affected.
  • Flank pain: Experienced as very severe stabbing pain that is localized over the flank. Pain radiates to the lower back either on the left or right side.
  • Abdominal tenderness: When the abdomen is palpated in the upper areas, severe pain can be appreciated over the epigastrium. This abdominal pain is not associated with guarding or rebound pain.

Renal infarction diagnosis

Often times, when renal infarction happens acutely, it is in the emergency room due to the patient feeling severe pain in the lower back and abdominal area. Once a brief history and physical exam are taken, imaging tests will confirm that a renal infarct has actually taken place. The following are some tests that are likely to be done in a suspected case of renal infarction:

  • CT or MRI scan: Gives a detailed look at the arteries supplying the kidneys
  • Urinalysis: Will help determine if blood is present in the urine as well as protein and white blood cells
  • Blood test: Will check to see if all blood values are in normal ranges, looking for signs of anemia
  • Doppler ultrasound: May be able to reveal any calcification or renal aneurysms

Treating renal infarction

The underlying cause of the renal infarct will dictate what type of treatment is most optimal. If it is due to a blood clot, the use of an anticoagulant will be the best choice. If the renal infarct is due to uncontrolled levels of high blood pressure, controlling it with hypertensive medication would be in order.

In cases of severe infarction, hospital admission will be required, where conservative treatment with adequate fluid intake and analgesic medication will take place. In cases of severe blockage of the renal artery, surgery may be required.

Related: Renal diet: Foods to eat and avoid for kidney failure


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Sources:

http://www.angiologist.com/general-medicine/renal-infarction/
https://radiopaedia.org/articles/renal-infarction

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