Editing Renal infarction


May involve the whole kidney (renal artery occlusion) or small areas of cortex and medulla

== Aetiology ==

* Trauma
* Embolism
** AF
** Atrial or mural thrombi
** Intracardiac mass
** Valvular lesions
* Iatrogenic complications of endovascular procedures
* Thrombotic
** Atherosclerotic disease of aorta/renal arteries
** Fibromuscular hyperplasia
** Takayasu's arteritis
** Polyarteritis nodosa
** Marfan's syndrome
** Ehler's-Danlos syndrome
** Hypercoagulable states
** Inflammatory diseases of retroperitoneum

== Presentation ==

* 25% asymptomatic
* Loin/flank/abdominal pain
* Nausea and vomiting
* Hypertension secondary to abrupt release of renin from infarcted segment
* AKI
* Fever, leucocytosis

== Investigation ==

* Urinalysis - proteinura and haematuria
* CT with IV contrast - look for areas of cortex not perfused

== Management ==

* Usually conservative
* Identify underlying cause
** ECG
** TTE
** Potential vasculitis screen
* Treat any hypercoagulable states/embolic syndromes with anticoagulation if necessary


== Renal vein thrombosis ==

* Rare
* Aetiology:
** Children - severe dehydration
** Nephrotic syndrome
** Renal tumours
** Hypercoagulable states
** Surgery 
** Trauma to renal vessels
* Management
** Systemic anticoagulation

[[Category:Urology]]