Ver el código de «Renal infarction»

==Background==
*Low ED incidence, approximately 1 per 90 to 100, 000 visits a year
*Diagnosis frequently missed due to mimicking symptoms similar to other more frequent complaints such as [[pyelonephritis]] and [[nephrolithiasis]]
*Caused by interruption of blood supply to kidney

===Major causes===
*Cardioembolic disease 
*Renal artery injury
*[[Hypercoagulable state]]
*[[Dissection]]
*[[Vasculitis]]

==Clinical Features==
*[[Flank pain]]
*[[Nausea]], [[vomiting]]
*Sudden onset

==Differential Diagnosis==
{{Flank pain DDX}}

==Evaluation==
===Laboratory===
*CBC with differential, CMP, LDH, urinalysis, urine culture
* [[EKG]]- to evaluate for arrhythmia  

===Imaging<ref>Decoste R, Himmelman JG, Grantmyre J. Acute renal infarct without apparent cause: A case report and review of the literature. Canadian Urological Association Journal. 2015;9(3-4):E237-E239. doi:10.5489/cuaj.2466.</ref>===
*CT with IV contrast (preferred study)
*[[Renal ultrasound]] - less senstive
*MRI with gadolinium (contraindicated with severe renal impairment due to risk of nephrogenic systemic fibrosis)
*Radioisotope scan - not commonly used

==Management==
*No clinical guidelines available, but mainstays of therapies include anticoagulation and endovascular therapy
*Endovascular therapy (thrombolysis/thrombectomy/angioplasty)
**Indicated if acute occlusion involving main renal artery or segmental branches
**Greatest likelihood of benefit if performed early
*Anticoagulation:
**IV [[Heparin]] followed by oral [[Coumadin]]
**Indicated in patients with renal infarction in the setting of Atrial fibrillation, LV thrombus, and hyper coagulable state

==Disposition==
*Admit

==See Also==


==References==
<references/>

[[Category:Renal]]