Renal 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.
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.
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:
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:
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:
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.