Locations Main Campus: Chesterfield, MO 63017   |   Locations
314-434-1500 314-434-1500   |   Contact Us

Multimedia Encyclopedia

BACK
TO
TOP
 
E-mail Form
Email Results

 
 
Print-Friendly
Bookmarks
bookmarks-menu

Acute arterial occlusion - kidney

Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery

 

Acute arterial occlusion of the kidney is a sudden, severe blockage of the artery that supplies blood to the kidney.

Causes

 

The kidneys need a good blood supply. The main artery to the kidney is called the renal artery. Reduced blood flow through the renal artery can hurt kidney function. A complete blockage of blood flow to the kidney can often result in permanent kidney failure.

Acute arterial occlusion of the renal artery can occur after injury or trauma to the abdomen, side, or back. Blood clots that travel through the bloodstream ( emboli ) can lodge in the renal artery. Pieces of plaque from the walls of the arteries can come loose (on their own or during a procedure). This debris can block the main kidney artery or one of the smaller vessels.

The risk of renal artery blockages increases in people who have certain heart disorders, which make them likely to form blood clots. These include mitral stenosis and atrial fibrillation .

A narrowing of the renal artery is called renal artery stenosis . This condition increases the risk of a sudden blockage.

 

Symptoms

 

You may not have symptoms when one kidney does not function because the second kidney can filter the blood. However, high blood pressure (hypertension) may come on suddenly and be difficult to control.

If your other kidney is not working fully, blockage of the renal artery may cause symptoms of acute kidney failure . Other symptoms of acute arterial occlusion of the renal artery include:

  • Abdominal pain
  • Abrupt decrease in urine output
  • Back pain
  • Blood in the urine
  • Flank pain or pain in the side
  • Symptoms of high blood pressure such as headache, change in vision, and swelling

Note: There may be no pain. Pain, if it is present, most often develops suddenly.

 

Exams and Tests

 

The health care provider will not be able to identify the problem with just an exam unless you have developed kidney failure.

Tests you may need include:

  • Duplex Doppler ultrasound exam of the renal arteries to test blood flow
  • MRI of the kidney arteries, which can show a lack of blood flow to the affected kidney
  • Renal arteriography shows the exact location of the blockage
  • Renal nuclear scan shows a lack of blood flow to the affected kidney
  • Ultrasound of the kidney to check kidney size

 

Treatment

 

Often, people do not need treatment. Blood clots may get better on their own over time.

You may have treatment to open the artery if the blockage is discovered quickly or it is affecting the only working kidney. Treatment to open the artery may include:

  • Clot-dissolving medicines (thrombolytics)
  • Medicines that prevent the blood from clotting (anticoagulants), such as warfarin (Coumadin)
  • Surgical repair of the renal artery
  • Insertion of a tube (catheter) into the renal artery to open the blockage

You may need temporary dialysis to treat acute kidney failure. Medicines to lower cholesterol may be needed if the blockage is due to clots from plaque buildup in the arteries.

 

Outlook (Prognosis)

 

Damage caused by arterial occlusion may go away. However, in most cases it is permanent.

If only one kidney is affected, the healthy kidney may take over filtering the blood and producing urine. If you have only one working kidney, arterial occlusion leads to acute kidney failure. This can develop into chronic kidney failure .

 

Possible Complications

 

Complications may include:

  • Acute kidney failure
  • Chronic kidney disease
  • High blood pressure
  • Malignant hypertension

 

When to Contact a Medical Professional

 

Call your provider if:

  • You stop producing urine
  • You feel sudden, severe pain in the back, flank, or abdomen.

Get emergency medical help right away if you have symptoms of arterial occlusion and have only one working kidney.

 

Prevention

 

In many cases, the disorder is not preventable. The most important way to reduce your risk is to stop smoking.

People at risk for developing blood clots may need to take anti-clotting medicines. Taking steps to control diseases related to atherosclerosis (hardening of the arteries) may reduce your risk.

 

 

Open References

References

DuBose TD Jr, Santos RM. Vascular disorders of the kidney. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 125.

Ruggenenti P, Cravede P, Remuzzi G. Microvascular and macrovascular diseases of the kidney. In: Taal MW, Chertow GM, Marsden PA, et al, eds. Brenner and Rector's The Kidney . 9th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 34.

Scolari F, Ravani P. Atheroembolic renal disease. Lancet . 2010;8:375(9726):1650-60. PMID: 20381857 www.ncbi.nlm.nih.gov/pubmed/20381857 .

 
  • Kidney anatomy

    Kidney anatomy - illustration

    The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and stimulating red blood cell production.

    Kidney anatomy

    illustration

  • Kidney - blood and urine flow

    Kidney - blood and urine flow - illustration

    This is the typical appearance of the blood vessels (vasculature) and urine flow pattern in the kidney. The blood vessels are shown in red and the urine flow pattern in yellow.

    Kidney - blood and urine flow

    illustration

  • Kidney blood supply

    Kidney blood supply - illustration

    The renal arteries supply the kidneys with blood.

    Kidney blood supply

    illustration

    • Kidney anatomy

      Kidney anatomy - illustration

      The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and stimulating red blood cell production.

      Kidney anatomy

      illustration

    • Kidney - blood and urine flow

      Kidney - blood and urine flow - illustration

      This is the typical appearance of the blood vessels (vasculature) and urine flow pattern in the kidney. The blood vessels are shown in red and the urine flow pattern in yellow.

      Kidney - blood and urine flow

      illustration

    • Kidney blood supply

      Kidney blood supply - illustration

      The renal arteries supply the kidneys with blood.

      Kidney blood supply

      illustration

    A Closer Look

     

    Talking to your MD

     

      Self Care

       

        Tests for Acute arterial occlusion - kidney

         
           

          Review Date: 5/19/2015

          Reviewed By: Charles Silberberg, DO, Private Practice specializing in nephrology, affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

           
           
           

           

           

          A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.



          Content is best viewed in IE9 or above, Firefox and Google Chrome browser.