Summary:
Renal artery embolism (RAE) is a rare disease. Urgent treatment is necessary, as ischaemia can cause irreversible
kidney damage in 60 to 90 minutes. RAE frequently clinically manifests as a pain similar to renal colic. Source of
embolus is predominantly the heart at atrial fibrillation. Laboratory findings are unspecific. Ultrasonography with
color Doppler imaging is essential. Kidney perfusion is low and upper urinary tract is undilated. Renal afunction
can be recognized by intravenous urography and at renal scintigraphy. In angiography, renal artery is closed with
thromboembolus. With no delay, transcatheter clot aspiration should be performed and fibrinolytic agents (tissue
plasminogen activator) should be topically administered. Continual heparinisation and later warfarinisation should
follow. In spite of successful revascularisation, parameters of kidney function can almost never reach that prior the
RAE and shrinkage of kidney becomes a frequent consequence. Treatment can be successful even in patients with
renal occlusion lasting over 90 minutes, since occlusion is often incomplete or significant collateral blood supply
exists. In conclusion, renal artery embolism must be considered in cases of flank pain in patients with certain risk
actors (especially atrial fibrillation). Ultrasonography with color Doppler imaging and urgent angiography of the
renal artery are necessary in these cases. Thromboembolus can be then aspirated, and kidney perfusedwith fibrinolytic
agent.
Key words:
renal colic, renal artery embolism, ultrasonography, angiography fibrinolytic agents.
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