Canis ISSN: 2398-2942

Kidney: thromboembolism

Synonym(s): Renal thromboembolism

Contributor(s): Jana Gordon, Phil Nicholls

Introduction

  • Occlusion of renal artery or vein with a thrombus or embolism.
  • Cause: hypercoagulable state, most commonly.
  • Signs: acute renal failure; asymptomatic for small thrombi/emboli.
  • Diagnosis: clinical findings consistent with acute renal failure: azotemia, electrolyte disturbances, metabolic acidosis, variably concentrated urine, uremia.
  • Treatment: treat underlying cause, drugs, surgery.
  • Prognosis: good for small vessels. Guarded to poor if large vessels occluded, dependent on underlying disease.
  • See also acute renal failure Kidney: acute kidney injury (AKI).

Pathogenesis

Etiology


Hypercoagulation Trauma
  • Trauma, eg road traffic accident.
  • Iatrogenic, eg after "Tru-cut" liver biopsy (trauma to large or small renal vessels after surgery).

Pathophysiology

  • Occlusion of renal artery or vein with a thrombus or embolism. Requires one or more of the following: hypercoagulable state, vascular stasis, endothelial damage.
  • Thrombi → lodge in lungs (frequently) or other organs, eg kidney:
    • Thrombus/embolus in major renal vessel → renal ischemia Kidney: ischemia and tubular damage → acute renal failure if extensive renal damage.
    • Thrombus/embolus in smaller vessel → occluded → renal infarct → ischemia → damaged renal tissue.

Timecourse

  • Acute.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers


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