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Acute arterial occlusion - kidney

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Contents of this page:

Illustrations

Kidney anatomy
Kidney anatomy
Kidney - blood and urine flow
Kidney - blood and urine flow
Kidney blood supply
Kidney blood supply

Alternative names    Return to top

Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery

Definition    Return to top

Acute renal arterial thrombosis is a sudden, severe blockage of the artery that supplies the kidney.

Causes, incidence, and risk factors    Return to top

The kidneys are very sensitive to the amount of blood that flows through them. Any reduction of blood flow through the renal artery can impair kidney function. If prolonged, a complete blockage of blood flow to the kidney often results in permanent failure of the kidney.

Lack of functioning of one kidney may not cause symptoms because the second kidney adequately filters the blood. Hypertension may develop, however. If there is not a second functional kidney, blockage of the renal artery may cause symptoms of acute kidney failure.

Acute arterial occlusion of the kidney may occur after injury or trauma to the abdomen, side, or occasionally the back. Emboli (blood clots that travel through the blood stream) may lodge in the renal artery.

The risk of emboli increases if there is a history of certain heart disorders such as mitral stenosis or atrial fibrillation. Individuals with disorders that make them highly likely to form clots may be particularly vulnerable to acute renal artery occlusions.

Occasionally, renal artery stenosis may increase the risk of a sudden occlusion due to clot formation.

Symptoms    Return to top

Note: There may be no pain. Pain, if present, usually develops suddenly.

Signs and tests    Return to top

Physical examination is generally unrevealing unless the disorder has persisted long enough to cause kidney failure.
This disease may also alter the results of an abdominal MRI.

Treatment    Return to top

Often, no specific treatment is recommended. Blood clots may resolve spontaneously in time.

If the blockage is discovered within a few hours of its occurrence, or if the affected kidney is the only functional kidney, attempts may be made to open the artery.

Attempts to open the artery may include use of clot-dissolving medications (thrombolytics) and medications that prevent the blood from clotting (anticoagulants) such as Coumadin.

Surgical repair of the artery or removal of the blockage with a catheter inserted into the artery by a radiologist may be required in some cases.

Treatment for acute renal failure may be appropriate.

Expectations (prognosis)    Return to top

If only one kidney is affected, the healthy kidney may take over filtering and urine production. Damage caused by arterial occlusion may be temporary, but it is usually permanent. If there is only one functional kidney, arterial occlusion results in acute renal failure that often persists as chronic renal failure.

Complications    Return to top

Calling your health care provider    Return to top

Call your health care provider if urine production stops, or if sudden, severe pain occurs in the back, flank, or abdomen.

If you have only one functional kidney and symptoms of acute arterial occlusion appear, go to the emergency room or call the local emergency number such as 911.

Prevention    Return to top

In many cases the disorder is not preventable. The most important way to reduce risk is to stop smoking.

Preventive use of anticoagulants may be recommended for people with a high risk of developing emboli such as those with mitral stenosis, atrial fibrillation, or coagulation disorders. Control of atherosclerotic disease may reduce risk.

Update Date: 1/19/2004

Updated by: Irfan A. Agha, M.D., Department of Medicine, St. Louis University, St. Louis, MO. Review provided by VeriMed Healthcare Network.

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