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Nefrología (Madrid)
On-line version ISSN 1989-2284Print version ISSN 0211-6995
Abstract
CARAVACA-FONTAN, Fernando et al. Acute renal infarction: Clinical characteristics and prognostic factors. Nefrología (Madr.) [online]. 2016, vol.36, n.2, pp.141-148. ISSN 1989-2284. https://dx.doi.org/10.1016/j.nefro.2015.09.015.
Introduction:
Acute renal infarction (ARI) is an uncommon disease, whose real incidence is probably higher than expected. It is associated with poor prognosis in a high percentage of cases.
Objectives:
To describe the main clinical, biochemical and radiologic features and to determine which factors are associated with poor prognosis (death or permanent renal injury).
Materials and methods:
The following is a retrospective, observational, single-hospital-based study. All patients diagnosed with ARI by contrast-enhanced computed tomography (CT) over an 18-year period were included. Patients were classified according to the cardiac or non-cardiac origin of their disease. Clinical, biochemical and radiologic features were analysed, and multiple logistic regression model was used to determine factors associated with poor prognosis.
Results:
A total of 62 patients were included, 30 of which had a cardiac origin. Other 32 patients with non-cardiac ARI were younger, had less comorbidity, and were less frequently treated with oral anticoagulants. CT scans estimated mean injury extension at 35%, with no differences observed between groups. A total of 38% of patients had an unfavourable outcome, and the main determinants were: Initial renal function (OR = 0.949; IC 95% 0.918-0.980; p = 0.002), and previous treatment with oral anticoagulants (OR = 0.135; IC 95% 0.032-0.565; p = 0.006).
Conclusions:
ARI is a rare pathology with non-specific symptoms, and it is not associated with cardiological disease or arrhythmias in more than half of cases. A substantial proportion of patients have unfavourable outcomes, and the initial renal function is one of the main prognostic factors.
Keywords : Oral anticoagulation; Auricular auricular fibrillation; Renal embolism; Acute renal infarction; Acute renal failure.