Renal embolism

Introduction Obstruction of renal blood vessels is an important cause of deterioration of renal function in the elderly, but the diagnosis of this disease is not easy, so special attention is needed. 90% of the embolus of renal artery embolism is derived from the heart. The cause of vascular occlusion may be embolism from a distant place, such as atrial fibrillation combined with a small atrial clot in the left atrium, and bacterial thrombosis caused by infective endocarditis. It can also be caused by an in situ vascular disease such as atherosclerosis, hematoma compression after trauma, or vasculitis. Renal embolism is mostly unilateral, but about 15% to 30% may occur simultaneously on both sides.

Cause

90% of the embolus of renal artery embolism is derived from the heart. The cause of vascular occlusion may be embolism from a distant place, such as atrial fibrillation combined with a small atrial clot in the left atrium, and bacterial thrombosis caused by infective endocarditis. It can also be caused by an in situ vascular disease such as atherosclerosis, hematoma compression after trauma, or vasculitis. Renal embolism is mostly unilateral, but about 15% to 30% may occur simultaneously on both sides.

an examination

Related inspection

Renal dynamic imaging renal angiography

The clinical manifestations of renal embolism vary widely, depending on the time of occurrence and severity. Acute onset will have sudden low back pain, knocking pain, and even fever, hematuria, nausea, vomiting and other symptoms. Kidney enzymes in the blood and urine may rise. Bilateral embolization can cause oliguria and acute renal failure.

Chronic renal embolism is mostly asymptomatic. Patients may have temporary high blood pressure, but high blood pressure may continue. Diagnosis mainly depends on renal artery angiography.

Differential diagnosis

1, acute appendicitis: right renal artery embolization appears right side of the waist, abdominal pain should be identified with high appendicitis. The latter was characterized by pain in the lower right abdomen, localized tenderness and abdominal muscle tension, without hematuria and sputum pain in the kidney, and no increase in blood and urine alkaline phosphatase and lactate dehydrogenase.

2, ureteral stones: there are paroxysmal cramps and hematuria. However, hematuria was aggravated at the onset of pain or after intense activity. The urinary tract plain film showed shadow of the stone, the retrograde pyelography ureteral catheter insertion was blocked, and the radionuclide kidney diagram showed an obstructive curve.

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