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
1 Department of Nephrology
2 Department of Vascular Surgery and
3 Department of Interventional Angiography.,
Hospital General Universitari Vall dHebron., Universitat Autnoma., Barcelona., Spain
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.
Received Date: 11/1/2008 Revision Received Date: 7/2/2008 Acceptance Date: 11/2/2008 Electronic publication date: 21/2/2008
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* Address correspondence to this author at the Department of Nephrology., Hospital General Universitari Vall d'Hebron., Universitat Autónoma., Pº Vall D'Hebron 119-129., 08035., Barcelona., Spain, Tel: +34934893000., Ext. 6476, Fax: + 34 932746204, E-mail: firstname.lastname@example.org