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Acute arterial occlusion of the kidney Causes and Risks:
The kidneys are very sensitive to the amount of blood flow through them. Any reduction of blood flow through the renal artery can impair kidney function. A complete blockage of blood flow usually causes permanent failure of the kidney.
Lack of functioning of one kidney may not cause symptoms because the second kidney adequately filters the blood. Hypertension may develop, however. If there is not a second functional kidney, blockage of the renal artery may cause symptoms of acute kidney failure .
Acute arterial occlusion of the kidney may occur after injury or trauma to the abdomen, side, or occasionally the back. Emboli (blood clots that travel through the blood stream) may lodge in the renal artery. The risk of emboli increases if there is a history of heart disorders such as mitral stenosis or atrial fibrillation . Smoking also increases the risk of developing emboli. Occasionally, renal artery stenosis or atheroembolic renal disease (the effects of atherosclerosis on the kidney) may cause sudden thrombosis ( clot ) of the renal artery.
Prevention:
In many cases the disorder is not preventable. The most important way to reduce risk is to stop smoking .
Preventive use of anticoagulants may be recommended for people with a high risk of developing emboli such as those with mitral stenosis or atrial fibrillation . Control of atherosclerotic disease may reduce risk.
Symptoms:
Note: There may be no pain. Pain, if present, usually develops suddenly.
Signs and Tests:
Physical examination is generally unrevealing unless the disorder has persisted long enough to cause kidney failure .
- An IVP may show no function of the affected kidney.
- A renal scan may indicate lack of blood flow to the affected kidney.
- Renal arteriography will show the exact location of the occlusion.
This disease may also alter the results of an abdominal MRI .
Treatment:
Often, no specific treatment is recommended. Blood clots may resolve spontaneously in time.
If the blockage is discovered within a few hours of its occurrence, or if the affected kidney is the only functional kidney, attempts may be made to open the artery.
Attempts to open the artery may include use of clot-dissolving medications (thrombolytics) and medications that prevent the blood from clotting (anticoagulants) such as Coumadin.
Surgical repair of the artery, or removal of the blockage with a catheter inserted into the artery by a radiologist, may be required in some cases.
Treatment for acute renal failure may be appropriate.
Prognosis:
The second kidney may take over filtering and urine production. Damage caused by arterial occlusion may be temporary, but it is usually permanent. If there is only one functional kidney, arterial occlusion results in acute renal failure that often persists as chronic renal failure .
Complications:
Call Your Healthcare Provider:
Call your health care provider if urine production stops, or if sudden severe pain occurs in the back, flank, or abdomen.
If you have only one functional kidney and symptoms of acute arterial occlusion appear, go to the emergency room or call the local emergency number (such as 911).
The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and the stimulation of red blood cell production. The gross anatomical structure of the kidney is illustrated.
This is the typical appearance of the blood vessels (vasculature) and urine flow pattern in the kidney. The blood vessels are shown in red and the urine flow pattern in yellow.
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