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Renal Embolism

Embolism Kidney


Presentation

  • A 37-year-old man who underwent total aortic arch replacement owing to aortic dissection, presented with a 3-h history of fever, chills, and acute right-sided flank pain.[ncbi.nlm.nih.gov]
  • Abstract A 66-year-old woman presented with acute-onset rapid atrial fibrillation and right upper quadrant pain which had appeared 24 h prior to admission. The patient also manifested acute oliguric renal failure (serum creatinine 6.9 mg/dl).[ncbi.nlm.nih.gov]
  • A 47-year-old woman, a non-smoker, presented with progressive dyspnea on exertion for two weeks.[medical-case-reports.imedpub.com]
  • Most cases presented with the patient in the sixth decade of life and commonly presented as abdominal or flank pain, fever, leukocytosis, and hematuria.[journals.lww.com]
  • Case Presentation A 58-year-old male patient presented to the emergency department with abrupt onset left abdominal pain. The pain radiated to his back and was not accompanied with other symptoms such as vomiting, diarrhea, dysuria, or fever.[omicsonline.org]
Hyperthermia
  • Pagina 441 - Dantrolene: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic use in malignant hyperthermia, the neuroleptic malignant syndrome and an update of its use in muscle spasticity. ‎[books.google.ro]
  • Seite 441 - Dantrolene: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic use in malignant hyperthermia, the neuroleptic malignant syndrome and an update of its use in muscle spasticity. ‎[books.google.de]
Right Upper Quadrant Pain
  • Abstract A 66-year-old woman presented with acute-onset rapid atrial fibrillation and right upper quadrant pain which had appeared 24 h prior to admission. The patient also manifested acute oliguric renal failure (serum creatinine 6.9 mg/dl).[ncbi.nlm.nih.gov]
  • Thirty (68%) patients had generalized abdominal pain, 14 (32%) had lumbar pain, 3 (7%) had right upper quadrant pain, 18 (41%) had fever, 3 (7%) had both fever and abdominal pain, and 6 (14%) had both lumbar pain and fever.[journals.lww.com]
Steatorrhea
  • Pagina 157 - Poley, JR: Role of bile acid malabsorption in pathogenesis of diarrhea and steatorrhea in patients with ileal resection. I. Response to cholestyramine or replacement of dietary long chain triglyceride by medium chain triglyceride. ‎[books.google.ro]
  • Seite 157 - Poley, JR: Role of bile acid malabsorption in pathogenesis of diarrhea and steatorrhea in patients with ileal resection. I. Response to cholestyramine or replacement of dietary long chain triglyceride by medium chain triglyceride. ‎[books.google.de]
Left Flank Pain
  • Ten minutes after the procedure the patient experienced sudden-onset of severe back and left flank pain accompanied by nausea and vomiting.[thefreelibrary.com]
Failure to Thrive
  • On the other hand, a severe RTA often results in renal stones, hypokalemia, or failure to thrive. This woman had dyspnea but no other suggesting symptoms for PE. Thanks to CT angiography, it was eventually demonstrated.[medical-case-reports.imedpub.com]
Hypertension
  • Percutaneous angioplasty in clinical management of renovascular hypertension: initial and long-term results. ‎[books.google.ro]
  • Renal atheroembolism rarely causes hypertension. Abdominal pain, nausea, and vomiting can result from concomitant compromised arterial microcirculation of abdominal organs (eg, pancreas, GI tract).[merckmanuals.com]
  • We believe that the development of oliguria in this patient was the direct result of acute severe pulmonary hypertension triggered by a PE.[academic.oup.com]
Irregularly Irregular Heart Rhythm
  • There was an irregularly irregular heart rhythm and tenderness on the right upper and lower quadrants. No CVA tenderness or peritoneal signs were elicited.[ncbi.nlm.nih.gov]
Ejection Murmur
  • Stein also wrote a book, A Physical and Physiological Basis for the Interpretation of Cardiac Auscultation: Evaluations Based Primarily on Second Sound and Ejection Murmurs .[books.google.de]
Muscle Spasticity
  • Pagina 441 - Dantrolene: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic use in malignant hyperthermia, the neuroleptic malignant syndrome and an update of its use in muscle spasticity. ‎[books.google.ro]
  • Seite 441 - Dantrolene: a review of its pharmacodynamic and pharmacokinetic properties and therapeutic use in malignant hyperthermia, the neuroleptic malignant syndrome and an update of its use in muscle spasticity. ‎[books.google.de]
Thigh Pain
  • The presentation of PE includes cough, orthopnea, wheezing, pleuritic pain, calf/thigh pain or swelling, or hemoptysis. There may be hypoxemia, widened alveolararterial gradient and respiratory alkalosis.[medical-case-reports.imedpub.com]
Flank Pain
  • A 37-year-old man who underwent total aortic arch replacement owing to aortic dissection, presented with a 3-h history of fever, chills, and acute right-sided flank pain.[ncbi.nlm.nih.gov]
  • All the patients presented with abdominal or flank pain. The sites of ARE were the right kidney in 57% of the patients, the left kidney in 36% of the patients, and both the kidneys in 6% of the patients.[ncbi.nlm.nih.gov]
  • A 31-year-old female was admitted with sudden onset severe right flank pain, vomiting, anorexia, and hematuria. She reported a similar episode of flank pain and vomiting one month prior, which had subsided spontaneously.[sjkdt.org]
  • The most common initial symptom was flank pain. The literature from 1970 to 1982 was reviewed to determine the current operative mortality (11%) and frequency of kidney salvage (67% to 90%) with surgery or anticoagulation.[jamanetwork.com]
  • Initial symptoms included flank pain (seven cases), abdominal or chest pain alone (seven), and nausea and vomiting (eight). Fever ( 37.5 C) occurred in 10 cases and flank tenderness in only eight.[annals.org]
Hematuria
  • Although our patient had hematuria, this may often be absent in patients with RAE. [8] It is postulated that absence of hematuria may be associated with worse renal function, since it may reflect hypoperfusion of the infracted area with reduction of glomerular[sjkdt.org]
  • Indeed, there was almost a significant difference in the patients with hematuria who had normal renal function (10 of 21) compared to the patients without hematuria who had normal renal function (5 of 18, p 0.059), indicating that the absence of hematuria[journals.lww.com]
  • Abdominal pain was common, as well as hematuria and an elevated LDH. These patients are at risk of subsequent embolic events to other organs.[ncbi.nlm.nih.gov]
  • […] proteinuria, microhematuria or hematuria.[urology-textbook.com]

Workup

  • Most patients are exposed to contrast during their diagnostic workup, placing them at risk for contrast nephropathy.[ncbi.nlm.nih.gov]
  • A negative d -dimer assay result combined with a low pretest probability determined by a well-validated clinical prediction rule suffices to rule out VTE; no further workup is necessary in such cases, even in patients who have had a prior VTE. 4, 9 –[aafp.org]
Microcytic Anemia
  • There’s a microcytic anemia resulted largely from menstrual overflow due to adenomyosis. D-dimer level was elevated. A pulmonary function test revealed FEV1 79% with a severe gas exchange reduction. Chest radiograph was unrevealing.[medical-case-reports.imedpub.com]
Hypertriglyceridemia
  • Hypoalbuminemia (serum albumin 34 g/L), hypercholesterolemia, and hypertriglyceridemia were recorded but were not required for the diagnosis of nephrotic syndrome.[pubs.rsna.org]

Treatment

  • Treatment of Kidney Infarction Conservative Treatment of Kidney Infarction: Cornerstones of conservative treatment are analgesics, regulation of blood pressure and systemic heparinization.[urology-textbook.com]
  • Newer treatment modalities, including intra-arterially injected low-dose streptokinase and percutaneous transluminal angioplasty, have also proved useful.[jamanetwork.com]
  • […] therapy, endovascular treatment and embolectomy.[books.google.ro]
  • Links: treatment General Practice Notebook General Practice Notebook The information provided herein should not be used for diagnosis or treatment of any medical condition.[gpnotebook.com]
  • It is difficult to compare the therapeutic effects of various treatment modalities ( Figure 4 ). Figure 4: Treatment for renal artery embolism.[omicsonline.org]

Prognosis

  • Patients with renal atheroemboli have a poor overall prognosis.[merckmanuals.com]
  • Renal biomarkers and prognosis in acute pulmonary embolism Thomas M Berghaus , Martin Schwaiblmair , Wolfgang von Scheidt Department of Cardiology, Respiratory Medicine and Intensive Care, Klinikum Augsburg, Ludwig-Maximilians-University Munich, Germany[heart.bmj.com]
  • Renal biomarkers and prognosis in acute pulmonary embolism Thomas M Berghaus, Martin Schwaiblmair, Wolfgang von Scheidt Department of Cardiology, Respiratory Medicine and Intensive Care, Klinikum Augsburg, Ludwig-Maximilians-University Munich, Germany[heart.bmj.com]
  • Long-term prognosis is usually poor. Treatment aims to prevent further embolization. Atheromatous plaque rupture usually results from manipulation of the aorta or other large arteries during vascular surgery, angioplasty, or arteriography.[merckmanuals.com]

Etiology

  • We conclude that the etiology of the acute renal insult in this patient is probably related to unilateral renal arterial embolization accompanied by arterial spasm of the unaffected kidney.[ncbi.nlm.nih.gov]
  • Etiology of embolism was cardiogenic in 55% and idiopathic in 45%. Mean s-Cr level was 1.2 mg/dL (range, 0.6-3.7 mg/dL). s-Cr elevation 0.5 mg/dL was detected in 19% of patients during the follow-up (6 of 31 patients; mean duration, 31 months).[ncbi.nlm.nih.gov]
  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • MANY clinical and experimental studies have been performed to study the etiology, diagnosis and treatment of traumatic fat embolism. Recently, a less well understood counterpart, termed "nontraumatic fat embolism," has been recognized.[nejm.org]
  • The symptoms were eventually completely gone after relief of the individual underlying etiologies one by one.[medical-case-reports.imedpub.com]

Epidemiology

  • Indian J Nephrol 2 Abdominal thromboses of splanchnic, renal and ovarian veins Valerio De Stefano,Ida Martinelli Best Practice & Research Clinical Haematology. 2012; 25(3): 253 3 Epidemiology and pathophysiology of nephrotic syndrome-associated thromboembolic[indianjnephrol.org]
  • The few case series that have been reported have described the epidemiology and clinical characteristics of this diagnosis. These series have also commented on the utility of various diagnostics, including laboratory tests and imaging modalities.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • Indian J Nephrol 2 Abdominal thromboses of splanchnic, renal and ovarian veins Valerio De Stefano,Ida Martinelli Best Practice & Research Clinical Haematology. 2012; 25(3): 253 3 Epidemiology and pathophysiology of nephrotic syndrome-associated thromboembolic[indianjnephrol.org]
  • […] been recognized as one of the complications of nephrotic syndrome since 1840. [1] Although it was initially thought to be the cause rather than the effect of nephrotic syndrome, today, it is clear that the hypercoagulable state is the result of several pathophysiological[sjkdt.org]
  • The pathophysiology of renin release in renovascular hypertension. [Review] [69 refs] Semin Nephrol. 2000;20:394–401. [ PubMed ] 12. Gasparini M, Hofmann R, Stoller M. Renal artery embolism: Clinical features and therapeutic options.[ncbi.nlm.nih.gov]

Prevention

  • Dysfunction as a Predictor of Stroke and Systemic Embolism in Patients With Nonvalvular Atrial Fibrillation Validation of the R(2)CHADS(2) Index in the ROCKET AF (Rivaroxaban Once-daily, oral, direct factor Xa inhibition Compared with vitamin K antagonism for prevention[research.ed.ac.uk]
  • Prevention Embolism can be prevented in high risk patients through antithrombotic drugs such as heparin, venous interruption, gradient elastic stockings, and intermittent pneumatic compression of the legs.[medical-dictionary.thefreedictionary.com]
  • Other important preventive measures include, secondary prevention of atherosclerotic risk factors, avoiding anticoagulant therapy, forbidding any new radiologic and/or vascular surgery procedure (8).[thefreelibrary.com]
  • Therefore, the treatment should focus on the prevention of subsequent embolism to other vital organs. Copyright 2015 Elsevier Inc. All rights reserved.[ncbi.nlm.nih.gov]
  • This unique publication explores diverse themes relating to thrombosis and embolism, from basic research at cell and molecular level to the actual care, prevention, and treatment of diverse categories of patients suffering from such diseases.[books.google.ro]

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