Renal Artery Embolism: Prospective Study of 41 Patients Based on a Diagnostic and Therapeutic Algorithm
Joan Fort1, *, Alfons Segarra11, Manel Matas2, Antonio Segarra3, Joaquim Camps1
Identifiers and Pagination:Year: 2008
First Page: 9
Last Page: 15
Publisher Id: TOUNJ-1-9
Article History:Received Date: 11/1/2008
Revision Received Date: 7/2/2008
Acceptance Date: 11/2/2008
Electronic publication date: 21/2/2008
open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
Renal artery embolism (RAE) is an underdiagnosed condition leading to acute renal failure in patients with a single functioning kidney. We prospectively studied 41 patients according to a previously validated algorithm based on Lactate Dehydrogenase (LDH) determination., which enables us to identify RAE patients and allocate them to a different protocolled treatment.
The most frequent symptom was atypical low back pain. Atrial fibrillation was present in 65.8% of patients. The most frequent site of the embolism was the main renal artery of a single kidney. Surgery was performed in 13 patients., fibrino-lytic treatment in 17 and anticoagulation in 11. Mean LDH levels were 1690 ± 1108 U/L. Oliguria was present in 15 pa-tients. Hemodialysis requirements were not different between patients with main RAE or intrarenal embolism., or according to treatment group.
Our results indicate that the use of a diagnostic algorithm based on LDH values is useful for identifying RAE patients. Further randomized trials are needed to compare results on treatment.