Introduction and Objectives
Acute renal infarction is an often missed yet an established entity in patients with cardio-vascular risk factors. Britain has got the highest incidence of ischemic heart disease and the fastest growing geriatric population in Europe, therefore more thrombo-embolic pathology involving the renal tract can be expected.
Material and Methods
Data of 434 patients with a clinical diagnosis of ureteric colic and haematuria was reviewed retrospectively presenting between January 2007 and December 2008. 22 patients with persistent pain and/or raised inflammatory parameters with no evidence of obstructive uropathy on IVU (182) or non-contrast CT (252) underwent contrast enhanced CT scans. Cardio-vascular risk factors were concomitantly noted.
Out of the group having contrast CT, 5 patients (3 males, 2 females) with mean age was 67.3 years, were shown to have renal infarctions (2 right & 3 left kidney). Single infarct was seen in 1 while multiple infarcts were noted in 4 cases. Overall 1.15% cases of the cohort demonstrated renal infarction. 3 patients had rate controlled atrial fibrillation and 2 had a previous myocardial infarction.
Acute renal embolus is a rare entity, accurate data regarding presentation, laboratory tests, and diagnostic techniques and treatment is not yet available. In patients presenting with the triad of 1) high risk for thromboembolic event 2) persistent flank/abdominal pain 3) haematuria +/− raised inflammatory parameters having had a normal IVU/CT KUB, a contrast enhanced CT scan to rule out renal infarction should be considered.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.