Renal Artery Embolism: Prospective Study of 41 Patients Based on a Diagnostic and Therapeutic Algorithm
Alfons Segarra11
Manel Matas2
Antonio Segarra3
Joaquim Camps1
Authors Info & Affiliations
Abstract
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.
Conclusions:
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.
