Clinical Characteristics and Outcomes of Renal Infarction
- Abstract
- BACKGROUND: Renal infarction is a rare condition resulting from an acute disruption of renal blood flow, and the cause and outcome of renal infarction are not well established. STUDY DESIGN: Case series. SETTING & PARTICIPANTS: 438 patients with renal infarction in January 1993 to December 2013 at 9 hospitals in Korea were included. Renal infarction was defined by radiologic findings that included single or multiple wedge-shaped parenchymal perfusion defects in the kidney. PREDICTOR: Causes of renal infarction included cardiogenic (n=244 [55.7%]), renal artery injury (n=33 [7.5%]), hypercoagulable (n=29 [6.6%]), and idiopathic (n=132 [30.1%]) factors. OUTCOMES: We used recurrence, acute kidney injury (AKI; defined as creatinine level increase≥ 0.3mg/dL within 48 hours or an increase to 150% of baseline level within 7 days during the sentinel hospitalization), new-onset estimated glomerular filtration rate (eGFR)<60mL/min/1.73m(2) (for >3 months after renal infarction in the absence of a history of decreased eGFR), end-stage renal disease (ESRD; receiving hemodialysis or peritoneal dialysis because of irreversible kidney damage), and mortality as outcome metrics. RESULTS: Treatment included urokinase (n=19), heparin (n=342), warfarin (n=330), and antiplatelet agents (n=157). 5% of patients died during the initial hospitalization. During the median 20.0 (range, 1-223) months of follow-up, 2.8% of patients had recurrent infarction, 20.1% of patients developed AKI, 10.9% of patients developed new-onset eGFR<60mL/min/1.73m(2), and 2.1% of patients progressed to ESRD. LIMITATIONS: This was a retrospective study; it cannot clearly determine the specific causal mechanism for certain patients or provide information about the causes of mortality. 16 patients were excluded from the prognostic analysis. CONCLUSIONS: Cardiogenic origins were the most important causes of renal infarction. Despite aggressive treatment, renal infarction can lead to AKI, new-onset eGFR<60mL/min/1.73m(2), ESRD, and death.
- All Author(s)
- Y. K. Oh
; C. W. Yang
; Y. L. Kim
; S. W. Kang
; C. W. Park
; Y. S. Kim
; E. Y. Lee
; B. G. Han
; S. H. Lee
; S. H. Kim
; H. Lee
; C. S. Lim
- Issued Date
- 2016
- Type
- Article
- Keyword
- Renal infarction; acute kidney injury (AKI); cardiogenic etiology; case series; end-stage renal disease (ESRD); kidney function; mortality; outcomes; parenchymal perfusion defect; reduced glomerular filtration rate; renal blood flow
- Publisher
- National Kidney Foundation
- ISSN
- 0272-6386
- Citation Title
- American Journal of Kidney Diseases
- Citation Volume
- 67
- Citation Number
- 2
- Citation Start Page
- 243
- Citation End Page
- 250
- Language(ISO)
- eng
- DOI
- 10.1053/j.ajkd.2015.09.019
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/1197
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