A renal infarction is a rare – and therefore often missed – cause of kidney problems resulting in a decline in kidney function. A sudden interruption of the blood supply of the renal vein due to a clot or narrowing occurs mainly in adults and the elderly. In rare cases, occlusion can also develop in newborn babies. Rapid diagnosis and adequate treatment are important to limit the short- and long-term consequences. However, because the complaints are often unclear, the diagnosis is not always made in time. Blockage of the renal artery or a major branch of a blood vessel in the kidney is rare but often serious. Usually the clot comes from another place in the body and ends in a relatively smaller blood vessel. The blockage can also occur in the kidney itself due to damage to the artery or a narrowing of the blood vessel.
- Cause of renal infarction
- Symptoms of a blocked blood vessel in the kidney
- Diagnosis of an infarction in the kidney
- Treating a clot with medications or catheterization
- Consequences of tissue damage: renal insufficiency
Cause of renal infarction
There are several reasons why a kidney infarction can occur. If cardiovascular disease is already present, there is an increased risk of a clot developing in the kidney. A kidney infarction then occurs as a result of atrial fibrillation, heart inflammation, arteriosclerosis, a defective heart valve or a myocardial infarction. Fibrodysplasia occurs mainly in young women, where one or both renal arteries become narrowed due to the presence of fibrous material in the blood vessels. In the case of a renal infarction, there may also be the simultaneous presence of a clot in other blood vessels.
Blood clotting disorder
The presence of a blood clotting disorder, such as Factor V Leiden or APS (antiphospholipid syndrome), can be a possible cause of a clot in the kidney. In addition, (part of) a clot may be present in one of the other small blood vessels, such as vessels in the lungs, intestines, heart, brain, hands, feet or in the eyes. A clot in one of these places can sometimes cause serious problems, such as a stroke, myocardial infarction or tissue necrosis.
Symptoms of a blocked blood vessel in the kidney
With a small infarction or minor blockage of an artery or blood vessel, there are usually no symptoms. Gradually higher blood pressure may develop or existing high blood pressure may worsen. If there is a large infarction, severe and unexplained abdominal pain in the flank or back often occurs, accompanied by an increase in temperature or fever and/or nausea. Sometimes there is also blood in the urine. Urine production may decrease due to reduced kidney function.
Diagnosis of an infarction in the kidney
Blood tests show a sudden increase in the LDH level and sometimes also in the serum creatine level. LDH is an enzyme that is released when an organ is damaged. The values of the blood test raise suspicion, but the diagnosis can only be definitively made with additional research. The most reliable diagnosis is obtained by using angiography. However, this examination only takes place if the doctor is considering surgical removal of the clot. A CT scan or ultrasound examination can also show abnormalities, allowing the diagnosis to be made.
Treating a clot with medications or catheterization
Timely diagnosis is of great importance, both for proper treatment and for the prevention of a recurrence (recurrence) of a renal infarction or thrombosis formation in another blood vessel. A kidney infarction is combated by administering medications such as blood thinners, possibly in combination with blood pressure lowering agents. The anticoagulants are administered by injection or through an infusion. Later, these medicines can be taken via tablets. Sometimes a renal catheterization is performed, in which the blocked blood vessel is opened with a balloon and, if necessary, a stent is placed to keep the blood vessel open. In exceptional cases, the clot is surgically removed.Source: Dream designs / FreeDigitalPhotos.netTreatment of babies In babies, the clot is not treated; it dissolves spontaneously when more fluid is given to the baby, which increases urine production. The symptoms disappear gradually and completely within 10-15 days in newborn babies.
Consequences of tissue damage: renal insufficiency
Depending on the duration of the blood vessel blockage, the consequences can range from little to no damage to a long-term decline in kidney function. Kidney function may improve over time, but usually does not fully recover due to death of the kidney tissue (necrosis). The resulting necrosis can cause permanent renal insufficiency, which requires further treatment.
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