1. Renal Artery Embolism: Prospective Study of 41 Patients Based on a Diagnostic and Therapeutic Algorithm
- Author
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Alfons Segarra, Joaquim Camps, Antonio Segarra, Manel Matas, and Joan Fort
- Subjects
Kidney ,medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,Atrial fibrillation ,medicine.disease ,law.invention ,Surgery ,medicine.anatomical_structure ,Randomized controlled trial ,Embolism ,Nephrology ,Oliguria ,law ,medicine.artery ,Internal medicine ,medicine ,Cardiology ,Hemodialysis ,Renal artery ,medicine.symptom ,Prospective cohort study ,business - Abstract
Renal artery embolism (RAE) is an underdiagnosed condition leading to acute renal failure in patients with a single functioning kidney. We prospectively studied 41 patients according to a previously validated algorithm based on Lactate Dehydrogenase (LDH) determination, which enables us to identify RAE patients and allocate them to a different protocolled treatment. The most frequent symptom was atypical low back pain. Atrial fibrillation was present in 65.8% of patients. The most frequent site of the embolism was the main renal artery of a single kidney. Surgery was performed in 13 patients, fibri- nolytic treatment in 17 and anticoagulation in 11. Mean LDH levels were 1690 ± 1108 U/L. Oliguria was present in 15 pa- tients. Hemodialysis requirements were not different between patients with main RAE or intrarenal embolism, or accord- ing to treatment group. Conclusions: Our results indicate that the use of a diagnostic algorithm based on LDH values is useful for identifying RAE patients. Further randomized trials are needed to compare results on treatment.
- Published
- 2007
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