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renal infarct / infarction


clinical presentation

  • may present as renal colic or pyelonephritis with flank pain but neither of these will have an elevated LDH
  • 10% will have a fever
  • almost 20% have bilateral involvement
  • suspicion of renal infarct is usually after renal USS raises the possibility
  • many will develop transient hypertension in the 1st week

Initial Ix of possible renal infarct on renal USS

  • FBE, U&E, CRP, LFTs, LDH
    • in patients with flank pain, an elevated serum LDH (usually > 2-4x the upper limit of normal) with little or no rise in serum aminotransferases is strongly suggestive of renal infarction
      • other DDx of raised LDH with normal transaminases: late AMI, haemolysis, renal transplant rejection
    • WCC and CRP may be mildly raised
  • MSU m/c/s
    • 1/3rd will have haematuria
  • ECG to exclude AF

Rx of confirmed renal infarct

  • consider percutaneous endovascular therapy
    • best results are in the early stages of renal artery ambolism
  • consider angioplasty with stent placement for dissection
renal_infarct.txt · Last modified: 2021/09/04 03:19 by wh

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