Renal infarct (kidney damage from an area of blocked blood flow)


Description

A blockage of blood flow to an area of the kidney causing death of tissue in a small section of a kidney. Usually, a renal infarct happens when a blood clot (embolus) that has formed in the heart or on a heart valve floats through the circulation into the kidney. This blood clot then blocks flow to part of the kidney. The disorder is most commonly seen in patients with an infected heart valve (endocarditis) or heart failure. More rarely it is associated with: inflammation of the artery (vasculitis), trauma, cancer, or after surgery. The most common symptoms are back pain and bloody urine (hematuria).

Symptoms

Sudden onset of back pain, sudden onset of flank pain, bloody urine (hematuria).

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. The problem is usually seen on a CT scan. Blood tests to check kidney function and to identify blood clotting abnormalities will probably be done. An echocardiogram (heart ultrasound) is used to view heart valves, where a clot can originally form.

Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, Electrocardiogram (EKG), Magnetic resonance imaging (MRI), Urinalysis (UA), Ultrasound

Other Specific Tests: Angiography, renal scintigraphy, intravenous pyelography (IVP), PT (Protime), PTT (Partial Thromboplastin Time)

Specialists:
Nephrology, Pediatric Nephrology

Treatment

Most of the time a renal infarct is treated with pain medicines and the clot is not removed. However, the source of the clot needs to be found and treatment must be given to prevent recurrence. If this is a heart valve infection or problem, the treatment might include surgery or antibiotic treatment. 
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