Presentation
We present a case of acute renal artery thrombosis due to disseminated zygomycosis in a healthy young adult male.The diagnosis of renal artery occlusion was made on contrast-enhanced CT (CECT) and confirmation of etiology was made only on post mortem [ncbi.nlm.nih.gov]
We present an unusual case of a patient that presented with renal artery thrombosis and subsequently was diagnosed with neuroendocrine tumor. [austinpublishinggroup.com]
Entire Body System
- Renal Artery Stenosis
Doppler ultrasound of renal graft showed a moderate stenosis in the proximal transplant renal artery with a significant decrease of resistance index. [latunisiemedicale.com]
[…] level Symptoms of Renal Artery Stenosis Renal artery stenosis usually does not cause any specific symptoms. [webmd.com]
What is renal artery stenosis? Renal artery stenosis (narrowing) is a decrease in the diameter of the renal arteries. [medicinenet.com]
Renal artery stenosis care at Mayo Clinic Symptoms Renal artery stenosis may cause no signs or symptoms until the condition reaches an advanced state. Most people with renal artery stenosis have no signs and symptoms. [mayoclinic.org]
- Surgical Procedure
The decision whether to treat renal artery stenosis with medicine or with a surgical procedure depends on the situation. [emedicinehealth.com]
Surgical treatment may include: endovascular procedures such as angioplasty (the opening of a renal artery using a balloon or other method) or placement of a stent (a tiny expandable metal coil placed inside an artery to keep the artery open) open surgical [surgery.med.miami.edu]
It found that travelers who have recently undergone a surgical procedure or who have a malignant disease such as cancer or who are pregnant are most at risk. [en.wikipedia.org]
Another procedure sometimes performed for kidneys obtained from donors 2 Knowledge of the exact renal transplant procedure performed is essential for accurate interpretation of both normal and abnormal findings. [appliedradiology.com]
- Fatigue
Decreased renal function (azotemia), may present with symptoms of fatigue, malaise, and/or slight confusion due to a gradual buildup of waste products in the body. [emedicinehealth.com]
Symptoms of kidney failure may include: bad taste in the mouth chest pain confusion or anxiety fatigue itchy skin loss of appetite muscle twitching or cramping nausea and vomiting pale or yellowish-brown tinted skin puffy eyes, hands, and feet weight [medbroadcast.com]
- Pallor
Vascular spasms occur as a result of arterial constriction and in early stages may be difficult to distinguish them from thrombolytic states, which generally are followed by pallor and cyanosis of the limbs after the insertion of catheters 1, 2. [colombiamedica.univalle.edu.co]
Respiratoric
- Dyspnea
Limits in visualization of main renal arteries • Obesity • Overlying bowel gas • Dyspnea • Shadowing from arterial calcifications • Cardiac arrhythmias • Poor angle of Doppler insonation • Accessory renal arteries (small size) Moukaddam H et al. [slideshare.net]
Cardiovascular
- Hypertension
[…] for hypertension to develop after sudden renal-artery occlusion in man. [ncbi.nlm.nih.gov]
- Heart Disease
Risk factors are atrial fibrillation, mitral valve disease, coronary heart disease, heart failure, other heart diseases, cardiac surgery, aortic aneurysm, renal artery aneurysm or renal artery stenosis. [urology-textbook.com]
The most frequently used invasive procedure to open a narrowed renal artery uses the same type of procedure that is used in heart disease. [emedicinehealth.com]
Other complications include: Heart disease Stroke Heart attack Heart failure Damage to blood vessels Loss of vision When should I call my healthcare provider? If your symptoms get worse or you have new symptoms, tell your healthcare provider. [hopkinsmedicine.org]
Other factors that make vascular disease more likely include Family history of vascular or heart diseases Pregnancy Illness or injury Long periods of sitting or standing still Any condition that affects the heart and blood vessels, such as diabetes or [icdlist.com]
[…] onset of flank pain Hematuria Proteinuria Fever Leukocytosis Causes Trauma Blunt abdominal trauma Traumatic avulsion of renal artery Surgery Embolism Cardiac origin Rheumatic heart disease with arrhythmia Atrial fibrillation Myocardial infarction Prosthetic [learningradiology.com]
- Vascular Disease
Patients with underlying vascular disease may be risking cardiovascular complications from recreational or medical use of cocaine. [ncbi.nlm.nih.gov]
Patient Care & Services Renal Vascular Disease What is renal vascular disease? Renal vascular disease is the name given to a variety of complications that affect the arteries and veins of the kidneys. [surgery.med.miami.edu]
You are more likely to have vascular disease as you get older. [icdlist.com]
vascular diseases (VE) and a method for the diagnosis and assessment of vascular disease, wherein the presence or absence of or the peptide marker (s) indicative of the severity of a VE. [google.com.gt]
Skin
- Formication
The mobile phase for the CE separation consisted of 20% acetonitrile and 0.25% formic acid in water. For the "Sheath- flow" on the MS 30% isopropanol was used with 0.5% formic acid, here at a flow rate of 2 ul / min. [google.com.gt]
Urogenital
- Flank Pain
The only presenting symptom was left flank pain and no predisposing factors could be found on clinical or laboratory examination. [ncbi.nlm.nih.gov]
Sudden kidney failure when first taking an angiotensin-converting enzyme (ACE) inhibitor for blood pressure and/or heart treatment Renal Artery Thrombosis Sudden onset of side pain between the ribs and the upper border of the hip bone (flank pain), pain [hopkinsmedicine.org]
Case Presentation The patient is a 58-year-old previously healthy female that presented to the emergency department for acute onset of left-sided flank pain. [austinpublishinggroup.com]
- Kidney Failure
If only one kidney is affected, the healthy kidney may take over filtering the blood and producing urine. If you have only one working kidney, arterial occlusion leads to acute kidney failure. This can develop into chronic kidney failure. [m.ufhealth.org]
Increased urea (a waste product made by the kidneys) in the blood. Unexplained kidney failure. [hopkinsmedicine.org]
A thrombosis of a renal artery may cause kidney failure because of blocked blood flow to the kidney. [stanfordhealthcare.org]
These complications affect the blood circulation of the kidneys, and may cause damage to the tissues of the kidneys, kidney failure, and/or high blood pressure. [surgery.med.miami.edu]
- Renal Insufficiency
Twenty-five days later, he presented with acute renal insufficiency and uncontrolled hypertension. Angiography revealed in-stent thrombosis and collateral flow in the distal segment of the left renal artery. [ncbi.nlm.nih.gov]
General Considerations Thrombotic disease usually affects larger vessels Includes main renal artery Patients with thrombotic disease usually present with hypertension or renal insufficiency Usually results from atherosclerosis But, blunt abdominal trauma [learningradiology.com]
Long-term functional complications include renal insufficiency, renal tubular dysfunction and hypertension in up to 30% of patients[ 1, 8 ]. [ijponline.biomedcentral.com]
Atheroembolic renal disease is becoming a common cause of renal insufficiency (poor kidney function) in the elderly. Renal vein thrombosis – A renal vein thrombosis is the formation of a clot in a vein to the kidney. [surgery.med.miami.edu]
[…] the diagnosis of renovascular disease Unexplained rapid progression of renal insufficiency Treatment is with percutaneous transluminal angioplasty (PTA) plus stent placement or with surgical bypass of the stenotic segment. [merckmanuals.com]
- Renal Function Impairment
[…] loss of renal function. [karger.com]
Workup
Though easily treatable, this is a condition which is seldom investigated in the workup of thrombotic disorders. [ncbi.nlm.nih.gov]
Topics include: Non-neoplastic diseases in kidney cancer; Nephrectomy for non-neoplastic causes; Autopsy renal pathology; Practical approach to kidney donation workup; Kidney allograft pathology; Renal infections; Amyloidosis - all subtypes; Histologic [books.google.com]
Initial laboratory workup revealed a leukocytosis of 12.9 bil/L. Basic metabolic panel, including creatinine, was unremarkable and urinalysis was normal. Lactate dehydrogenase (LDH) was slightly elevated at 258 U/L. [austinpublishinggroup.com]
After a negative workup for secondary causes of renal infarct, including atrial fibrillation, vasculitis, hypercoagulability, endocarditis, and drugs, the foreign body was identified as the cause. [acgcasereports.gi.org]
A systematic approach can then be utilized to ensure that the vast majority of the possible complications are detected; particularly those that may require further diagnostic workup or surgical/radiologic intervention. [appliedradiology.com]
Serum
- Hypercholesterolemia
His medical history was remarkable for hypercholesterolemia, paroxysmal atrial fibrillation and transient ischemic attack. He was on Coumadin and his INR was 1.4. [members.sirweb.org]
Nephrotic syndrome is marked by abnormally low levels of albumin (hypoalbuminemia), abnormally high levels of cholesterol in the blood (hypercholesterolemia), and fluid retention (edema). [healthofchildren.com]
- Abnormal Renal Function
[…] predictive value for abnormal renal function rose to 96% and 67%, respectively. [slideshare.net]
Treatment
Renal arterial thrombosis because of blunt abdominal trauma is still an underreported entity, treatment for which has not yet been established. Both early nephrectomy and delayed revascularization are not justified treatment options. [ncbi.nlm.nih.gov]
Prognosis
However, the prognosis at present still remains poor. [ncbi.nlm.nih.gov]
Treatment and prognosis Acute renal artery occlusion is an emergency and requires immediate intervention. Treatment modalities include anticoagulation and thrombolysis/thrombectomy with renal artery stenting 1,3. Promoted articles (advertising) [radiopaedia.org]
The prognosis is variable depending upon the severity of lesions, whether unilateral or bilateral, comorbidities and co-existing atherosclerotic disease, age and response to medical or surgical therapy. [patient.info]
Outlook (Prognosis) Damage caused by arterial occlusion may go away. However, in most cases, it is permanent. If only one kidney is affected, the healthy kidney may take over filtering the blood and producing urine. [m.ufhealth.org]
Likewise, other factors such as blunt mechanisms, high-grade injuries (i.e. grade 5), and an attempted arterial repair are also associated with a poor prognosis [ 3 ]. [clinmedjournals.org]
Etiology
Clinical features with suspected etiologies are reviewed. Recommendations for future evaluations are given. [ncbi.nlm.nih.gov]
Liu discussed an article by Oh that found that the most common etiology was cardiogenic, followed by idiopathic, renal artery injury, and hypercoagulable state. Labs include an elevated LDH, hematuria, and occasionally leukocytosis. [imrespdx.com]
The etiologies of end stage renal disease reported in our study were: one case of nephronophtisis, one case of renal hypoplasia and one case of vesico-ureteral reflux. The etiology was unknown in one case. [latunisiemedicale.com]
Epidemiology
View Article Google Scholar Bökenkamp A, von Kries R, Nowak-Göttl U, Göbel U, Hoyer PF: Neonatal renal venous thrombosis in Germany between 1992 and 1994: epidemiology, treatment and outcome. Eur J Pediatr. 2000, 159: 44-48. 10.1007/s004310050008. [ijponline.biomedcentral.com]
In vitro data suggest that drugs such as cyclosporine and OKT3 increase the risk of thrombosis, but it has not been borne out in clinical practice. [8] Epidemiological data suggest increased risk of thrombosis in patients undergoing second transplant [ijtonline.in]
Epidemiology [ 3 ] The prevalence of atherosclerotic renal artery stenosis is high - about 7% in individuals older than 65 years and about 50% in patients with diffuse arterial disease, and it is increasingly frequent in an ageing population. [patient.info]
Liaño F, Pascual J: Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Madrid Acute Renal Failure Study Group. Kidney Int 1996;50:811-818. [karger.com]
Pathophysiology
An introductory section concisely explains the complex pathophysiology of thrombosis and hemostasis. [books.google.com]
Prevention
Abstract Epsilon aminocaproic acid (EACA) has been used to prevent rebleeding in patients with subarachnoid hemorrhage (SAH). [ncbi.nlm.nih.gov]
Doherty Lippincott Williams & Wilkins, 2006 - 826 من الصفحات This volume offers authoritative, evidence-based recommendations for preventing and managing complications in all current general surgery procedures. [books.google.com]
Prevention Renal vein thrombosis cannot be prevented. Preventing dehydration by maintaining fluids in the body may help reduce the risk of renal vein thrombosis. Parental concerns Most cases of renal vein thrombosis resolve without complication. [healthofchildren.com]