Renal artery embolism
Key points
- Acute renal arterial thrombosis is a sudden, severe blockage of the artery that supplies the kidney.
- The kidneys are very sensitive to the amount of blood that flows through them.
- Physical examination is generally unrevealing unless the disorder has persisted long enough to cause kidney failure.
- 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.
Alternative names
Acute renal arterial thrombosis; Acute arterial occlusion - kidney; Acute renal artery occlusion; Embolism - renal artery
Definition
Acute renal arterial thrombosis is a sudden, severe blockage of the artery that supplies the kidney.
Causes, incidence, and risk factors
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
- Flank pain or pain in the side, not colicky or spasmodic
- Abdominal pain
- Back pain
- Blood in the urine
Note: There may be no pain. Pain, if present, usually develops suddenly.
Signs and tests
Physical examination is generally unrevealing unless the disorder has persisted long enough to cause kidney failure.
- Kidney ultrasound is the initial diagnostic test of choice to identify renal artery occlusions.
- An IVP (intravenous pyelogram) may show no function of the affected kidney.
- A renal scan may indicate lack of blood flow to the affected kidney.
- Renal arteriography will show the exact location of the occlusion.
This disease may also alter the results of an abdominal MRI.
Treatment
Written and revised by
Gerald Hurowitz, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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