Renal infarction - Revision history

ClaireLewis: /* Major causes */

2019-01-27T00:38:28Z

Major causes

2018-09-13T20:08:39Z

References

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	==References==		==References==
	~~<ref>Antopolsky M, Simanovsky N, Stalnikowicz R, et al. Renal infarction in the ED: 10-year experience and review of the literature. Am J Emerg Med 2012; 30:1055.</ref>~~
	<references/>		<references/>

	[[Category:Renal]]		[[Category:Renal]]

2018-03-19T07:15:11Z

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	==Management==		==Management==
	*No clinical guidelines available, but mainstays of therapies include anticoagulation and endovascular therapy		*No clinical guidelines available, but mainstays of therapies include anticoagulation and endovascular therapy
	*Acute occlusion involving main renal artery or segmental branches:		*Endovascular therapy (thrombolysis/thrombectomy/angioplasty)
	**Endovascular therapy (thrombolysis/thrombectomy/angioplasty)		**Indicated if acute occlusion involving main renal artery or segmental branches
	***Greatest likelihood of benefit if performed early		**Greatest likelihood of benefit if performed early
	*Anticoagulation:		*Anticoagulation:
	**IV [[Heparin]] followed by oral [[Coumadin]]		**IV [[Heparin]] followed by oral [[Coumadin]]

2018-03-19T07:13:40Z

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	**Endovascular therapy (thrombolysis/thrombectomy/angioplasty)		**Endovascular therapy (thrombolysis/thrombectomy/angioplasty)
	***Greatest likelihood of benefit if performed early		***Greatest likelihood of benefit if performed early
	*Anticoagulation ~~is indicated~~ in patients with renal infarction in the setting of:		*Anticoagulation:
	**Atrial fibrillation		**IV [[Heparin]] followed by oral [[Coumadin]]
	**LV thrombus		**Indicated in patients with renal infarction in the setting of Atrial fibrillation, LV thrombus, and hyper coagulable state
	**Hypercoagulable state

	==Disposition==		==Disposition==

2018-03-19T07:08:57Z

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	==Management==		==Management==
			*No clinical guidelines available, but mainstays of therapies include anticoagulation and endovascular therapy
			*Acute occlusion involving main renal artery or segmental branches:
			**Endovascular therapy (thrombolysis/thrombectomy/angioplasty)
			***Greatest likelihood of benefit if performed early
			*Anticoagulation is indicated in patients with renal infarction in the setting of:
			**Atrial fibrillation
			**LV thrombus
			**Hypercoagulable state

	==Disposition==		==Disposition==
			*Admit

	==See Also==		==See Also==
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	==References==		==References==
			<ref>Antopolsky M, Simanovsky N, Stalnikowicz R, et al. Renal infarction in the ED: 10-year experience and review of the literature. Am J Emerg Med 2012; 30:1055.</ref>
	<references/>		<references/>

	[[Category:Renal]]		[[Category:Renal]]

2017-12-17T19:01:48Z

Evaluation

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

	Imaging:<ref>		===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>===
	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)		*CT with IV contrast (preferred study)
	*[[Renal ultrasound]] - less senstive		*[[Renal ultrasound]] - less senstive

2017-12-17T18:58:24Z

Clinical Features

2017-12-17T18:57:17Z

Background

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	==Background==		==Background==
	*Low ED incidence, approximately 1 per 90 to 100, 000 visits a year		*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		*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		*Caused by interruption of blood supply to kidney

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

2017-11-23T12:24:15Z

Differential Diagnosis

2017-11-23T12:23:24Z

Differential Diagnosis