Renal artery thrombosis

A rare and life-threatening condition in which one or both renal arteries become occluded by a thrombus, leading to reduced perfusion and AKI.

  • The most common cause of renal artery thrombosis is thromboembolism originating in the heart or large arteries.
  • Risk factors include hypercoagulability (smoking, contraceptives, inflammation), DM
  • Other reasons may be polycythemia vera, SLE, and iatrogenically (surgical procedures)
  • Often misdiagnosed, as the symptom is flank pain
  • Untreated, my proceed to kidney infarction

Investigations

  • CT angio
  • Ecocardiography to rule out intramural thrombosis (afib, prosthetic valve)
  • LDH
  • Urinalysis

Therapy

  • Heparin, DOAC

Renal vein thrombosis

A rare condition in which one or both renal veins become occluded by a thrombus.

  • Mostly seen in children with severe dehydration
  • In adults, it is associated with malignancy (most common, RCC invasion), nephrotic syndrome, and hypercoagulable states, renal transplantation
  • Thrombosis of the left renal vein (more common) will involve

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