Renal infarction. Analysis of 12 cases of acute renal artery occlusion

Introduction. Kidney infarction (KI) is a rare condition that most often develops as a result of renal artery thromboembolism and causes complete or partial loss of renal function. The diagnosis of this pathology is challangable. Objective. To analyze the features of diagnosis, clinical, laboratory and instrumental characteristics of renal infarction. To assess delayed changes in the renal parenchyma in patients with renal infarction. Materials and methods. Retrospective analysis of data from 12 patients with KI who were admitted to V.M. Buyanov Moscow City Clinical Hospital from 2018 to 2021 and consequent prospective analysis of the results of examination of these patients between 2 and 34 months after KI were done. Result. The mean age of the patients was 60,4 years. Eight patients were admitted to the hospital with surgical diagnoses. None of the patients was correctly diagnosed in the first 12 hours from the onset of the disease. Seven patients had atrial fibrillation. The most informative diagnostic method was contrast-enhanced renal computed tomography (CT) scan. The average lactate dehydrogenase (LDH) level was 1563,4 U/L, creatinine -149,5 pmol/L. Discussion. Evaluation of functioning parenchyma during the control examination showed that it volume was equal to volume of the parenchyma not involved in the infarction at the time of primary hospitalization. Delayed investigation also showed mild violation of the evacuation function on the affected side. Conclusions. Atrial fibrillation is the main risk factor for renal infarction development. Contrast-enhanced CT remains the most valuable method for detecting acute renal artery occlusion. Late diagnosis of the infarction is the main reason of futility of endovascular correction. It requires vigilance of urologists and surgeons in relation to this problem.