scholarly journals Acute renal artery thrombosis associated with the use of an oral contraceptive pill

2021 ◽  
Vol 10 (6-s) ◽  
pp. 8-10
Author(s):  
Kamel El-Reshaid ◽  
Shaikha Al-Bader ◽  
Zaneta Markova
Keyword(s):  
Oral Contraceptive ◽  
Renal Artery ◽  
Left Kidney ◽  
Oral Contraceptive Pill ◽  
Arterial Disease ◽  
Lateral Side ◽  
Renal Infarction ◽  
Ascending Infection ◽  
Dorsal Branch ◽  
Main Renal Artery

Peripheral, and even visceral, venous thromboembolism is a known complication of oral contraceptive drugs (OCPs) but arterial disease, leading to renal infarction, is rarely reported.  We describe a 36-year-old female patient who presented with sudden left loin pain for 2 days.  Ultrasound examination showed a wedge-shaped echogenic lesion at lateral side of the left kidney.  Computed tomography with contrast showed the area to be avascular and the arteriogram showed abrupt loss of the dorsal branch of left main renal artery, which lacked any deformities, confirming diagnosis of thrombosis-in-situe.  Moreover, the pelvicalyceal system did not show abnormality which ruled out ascending infection.  The patient did not have a family history or laboratory evidence of hypercoagulable disorder. An OCP was the only medication she had received in the previous 3 months. The OCP was discontinued, and the patient was treated with heparin for 3 days then Abixaban for 6 months.  Subsequent CT study with contrast, 3 months later, showed lateral kidney scar.  On follow up; she did not have subsequent thrombotic events up to 1 year.  Keywords: Abixaban, infarction, Kidney, oral contraceptive, thrombosis.

scholarly journals Isolated Spontaneous Renal Artery Dissection Presented with Flank Pain

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Shruti P. Gandhi ◽  
Kajal Patel ◽  
Bipin C. Pal
Keyword(s):  
Computed Tomography ◽  
Renal Artery ◽  
Ct Angiography ◽  
Final Diagnosis ◽  
Flank Pain ◽  
Vascular Pathology ◽  
Artery Dissection ◽  
Renal Infarction ◽  
Doppler Study ◽  
Main Renal Artery

Spontaneous renal artery dissection is a rare but important cause of flank pain. We report a case of isolated spontaneous renal artery dissection in 56-year-old man complicated by renal infarction presented with flank pain. Doppler study pointed towards vascular pathology. Computed tomography (CT) angiography was used to make final diagnosis which demonstrated intimal flap in main renal artery with renal infarction.

scholarly journals Correlation between Renal Artery Anatomy and Hypertension: A Retrospective Analysis of 3000 Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jiayi Shen ◽  
Lingchun Lyu ◽  
Xiaoyan Wu ◽  
Jiansong Ji ◽  
Chunlai Zeng ◽  
...  
Keyword(s):  
Renal Artery ◽  
Left Kidney ◽  
Laboratory Data ◽  
Renal Arteries ◽  
Renin Activity ◽  
Accessory Renal Artery ◽  
Undiagnosed Hypertension ◽  
Main Renal Artery ◽  
Artery Branch ◽  
Accessory Renal Arteries

Objective. To assess the correlation between renal artery anatomy and blood pressure in Undiagnosed Hypertension and Diagnosed Hypertension. Methods. The renal artery CT scanning imaging data and laboratory data of 3000 inpatients and outpatients were collected retrospectively in 4 centers of China. Morphometric parameters were assessed using the quantitative vascular analysis (unit: mM). Results. 687 cases (23.2%) had accessory renal arteries unilaterally, and 216 cases (7.3%) had bilateral accessory renal arteries, including left kidney 825 (27.9%) and right kidney 798 (27.0%). The presence of accessory renal arteries and renal artery branches was higher in the diagnosed hypertension group as compared with the undiagnosed hypertension group (MARB, p p < 0.001; ARA, p  < 0.001; others, p  < 0.001). Consequently, multivariate regression analysis showed that age (OR = 2.519 (95% CI: 0.990–6.411, p  < 0.001)), dyslipidemia (OR = 1.187 (95% CI: 0.960–1.454, p  = 0.007)), renal hilum Outside the main renal artery branch (MRAB) (OR = 2.069 (95% CI: 1.614–2.524, p  = 0.002)), and accessory renal artery (ARA) (OR = 2.071 (95% CI: 1.614–2.634, p  = 0.001)) were risk factors of hypertension. In addition, higher renin activity was associated with ARA patients (2.19 ± 2.91 vs. 1.75 ± 2.85, p  < 0.001). Conclusions. When comparing renal arteries side by side, the anatomical length of the renal arteries is significantly different. In addition, the prevalence of accessory renal arteries and renal artery branches is higher in the hypertension group. The auxiliary renal artery and the main renal artery branch outside the renal portal are independent factors of hypertension. Renal sympathetic nerve activity is affected by renin activity and is related to the accessory renal artery.

Abstract P187: Partial Renal Infarction Induces Hypertension

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Jie Zhang ◽  
Jin Wei ◽  
Gensheng Zhang ◽  
Shaohui Wang ◽  
Lei Wang ◽  
...  
Keyword(s):  
Mouse Model ◽  
Renal Artery ◽  
Left Kidney ◽  
Renin Angiotensin System ◽  
Plasma Renin ◽  
Renal Infarction ◽  
Salt Diet ◽  
Tnf Α ◽  
Renin Mrna ◽  
The Right

Renal infarction is an under-diagnosed and under-reported phenomenon. The U.S. incidence of renal infarction is estimated at 1.4%. Systemically thromboembolic originate from thrombus in the heart or aorta while renal infarction in situ typically involves the main renal artery or its branches. Acute or aggravated hypertension is commonly observed in previously normotensive or hypertensive patients with renal infarction. However, these pathophysiological mechanisms have not been elucidated. The goal of this study was to develop a hypertensive mouse model of renal infarction. Partial renal infarction was performed in C57BL/6 mice by ligating either the upper (LU) or lower (LL) branch of the renal artery in the left kidney while the right kidney remained intact. The mean arterial pressure (MAP) was continuously measured with a telemetry system in conscious mice fed 4 weeks of normal salt diet (NS) (0.4% NaCl) followed by 4 weeks of high salt diet (HS) (4% NaCl). Plasma renin concentration (PRC), renin mRNA in the kidney and TNF-α were measured. Body weight, salt and fluid intakes were similar in mice with LU and LL ligation compared with sham operated mice. The weight of the left kidney decreased by 16.3% in LU (118.1±8.9 mg) and 14.2% in LL (121.5±7.8 mg) compared with sham operated mice (141.0±9.5 mg) (n=6; p<0.05 vs sham). The right kidney weight increased by 41.5% in LU (201.3±15.6 mg) and 38.2% in LL (196.6±8.1 mg) compared with sham mice (142.2±8.8 mg) (n=6; p<0.01 vs sham). MAP in mice fed NS elevated by 25% in LU (119.4±12.9 mmHg) and 19.1% in LL (113.7±10.6 mmHg), compared with sham (95.4±4.7 mmHg) (n=4; p<0.05 vs sham). HS further increased the MAP to 124.2±17.4 mmHg in LU and 118.6±14.8 mmHg in LL mice. PRC decreased by 50.0% in LU (30.7±8.63 ng/ml) and 62.7% in LL (22.9±10.8 ng/ml), compared with sham operated mice (61.4±12.6 ng/ml) (n=6; p<0.05 vs sham). Expression of local renin mRNA in the left kidney was upregulated by 113.4% in LU and 64.1% in LL mice, compared with the sham. Inflammatory cytokines TNF-α was increased by 174.2% in LU and 106.3% in LL mice. In conclusion, we developed a mouse model of partial renal infarction with hypertension in C57BL/6 mice. The mechanism of hypertension may be due to the upregulation of local renin angiotensin system and inflammation.

scholarly journals Left inferior accessory renal arteries its embryological basis and clinical significance

2012 ◽  
Vol 7 (1) ◽  
pp. 65-68
Author(s):  
N Satyanarayana ◽  
R Guha ◽  
V Nitin ◽  
G Praveen ◽  
AK Datta ◽  
...  
Keyword(s):  
Renal Artery ◽  
Left Renal Vein ◽  
Left Kidney ◽  
Renal Arteries ◽  
Accessory Renal Artery ◽  
Inferior Pole ◽  
Vascular Variations ◽  
Male Cadaver ◽  
Main Renal Artery ◽  
Accessory Renal Arteries

The variations in origin of renal arteries are very common. During routine dissection of a male cadaver we found left accessory renal artery. The origin of accessory renal artery is immediately below main renal artery. The left inferior accessory renal arteries run towards inferior pole of left kidney, in the area where the left renal vein was leaving the left kidney. The vascular variations are very important for vascular surgeons, urologists, nephrologists, radiologists. DOI: http://dx.doi.org/10.3126/jcmsn.v7i1.5976 JCMSN 2011; 7(1): 65-68

Acute Embolic Occlusion of Renal Artery after the Bentall Procedure: the Role of Primary Renal Angioplasty

2020 ◽  
Author(s):  
Suci Indriani ◽  
Suko Adiarto ◽  
Hananto Andriantoro ◽  
Ismoyo Sunu ◽  
Taofan Siddiq ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Daily Practice ◽  
Artery Occlusion ◽  
Renal Infarction ◽  
Complete Disappearance ◽  
Renal Angioplasty ◽  
Bentall Procedure ◽  
Arterial Blood ◽  
Main Renal Artery

AbstractAcute renal occlusion is an uncommon emergency problem in daily practice. The diagnosis is often missed or delayed not only because of its rarity but also nonspecific of clinical presentation. Sudden and complete termination of arterial blood supply to the kidney may lead to renal infarction and a complete loss of renal function. Although the need of early revascularization is uniformly recommended, but the methods has not been established. We presented a case of acute thromboembolic renal artery occlusion in patient who had a history of Bentall's surgery. Renal infarction and artery occlusion were clearly visualized by computed tomography angiogram (CTA). The patient was successfully treated with angioplasty and stenting of main renal artery with complete disappearance of symptoms and recovery of his renal function.

scholarly journals Aortic dissection or renal infarction: Multislice computed tomographic angiography can tell

2012 ◽  
Vol 140 (9-10) ◽  
pp. 644-647
Author(s):  
Milos Stojanovic ◽  
Slobodanka Pena-Karan ◽  
Biljana Joves-Sevic ◽  
Tatjana Ilic ◽  
Miroslav Ilic
Keyword(s):  
Abdominal Pain ◽  
Aortic Dissection ◽  
Renal Artery ◽  
Left Kidney ◽  
Artery Occlusion ◽  
Renal Infarction ◽  
Computed Tomographic ◽  
Increased Risk ◽  
Renal Artery Occlusion ◽  
Msct Angiography

Introduction. Acute renal infarction as a consequence of renal artery occlusion often goes unrecognized, mostly due to the non-specific clinical features. A quick diagnosis, ideally within three hours of presentation, is a key to renal function recovery. Case Outline. A 62-year-old male patient was admitted with a sudden abdominal pain, right flank pain and nausea. He had a diastolic hypertension at admission and his previous medical history showed atrial fibrillation. Initial clinical diagnosis was aortic dissection. Laboratory findings included elevated lactate dehydrogenase (LDH) and serum creatinine levels. There were no signs of aortic dissection or aneurismatic lesions registered during a multislice computed tomographic (MSCT) angiography. However, MSCT angiography demonstrated left ?upper? renal artery thrombosis and renal infarction - avascular area of the upper two thirds of the left kidney sharply demarcated from the surrounding parenchyma. Both kidneys excreted the contrast. Anticoagulant therapy was initiated, along with antiarrythmic and antihypertensive medications. The follow-up by computed tomography was performed after nine weeks, and it showed a partial revascularization of the previously affected area. Conclusion. Concomitant presence of flank/abdominal pain, an increased risk for thromboembolism and an elevated LDH suggested a possibility of renal infarction. MSCT angiography is a non-invasive and accurate method in the diagnosis of renal artery occlusion and the resulting renal infarction.

scholarly journals Microdissection of the Human Renal Nervous System

Hypertension ◽  
2020 ◽  
Vol 76 (4) ◽  
pp. 1240-1246 ◽  
Author(s):  
Arturo García-Touchard ◽  
Eva Maranillo ◽  
Blanca Mompeo ◽  
José Ramón Sañudo
Keyword(s):  
Nervous System ◽  
Renal Artery ◽  
Renal Denervation ◽  
Left Kidney ◽  
Renal Nerves ◽  
Renal Nerve ◽  
Main Renal Artery ◽  
Area Under Roc Curve ◽  
Human Cadavers ◽  
The Right

Despite the use of renal denervation to treat hypertension, the anatomy of the renal nervous system remains poorly understood. We performed a detailed quantitative analysis of the human renal nervous system anatomy with the goal of optimizing renal denervation procedural safety and efficacy. Sixty kidneys from 30 human cadavers were systematically microdissected to quantify anatomic variations in renal nerve patterns. Contrary to current clinical perception, not all renal innervation followed the main renal artery. A significant portion of the renal nerves (late arriving nerves) frequently reached the kidney (73% of the right kidney and 53% of the left kidney) bypassing the main renal artery. The ratio of the main renal artery length/aorta-renal hilar distance proved to be a useful variable to identify the presence/absence of these late arriving nerves (odds ratio, 0.001 (95% CI, 0.00002–0.0692; P : 0.001) with a cutoff of 0.75 (sensitivity: 0.68, specificity: 0.83, area under ROC curve at threshold: 0.76). When present, polar arteries were also highly associated with the presence of late arriving nerve. Finally, the perivascular space around the proximal main renal artery was frequently occupied by fused ganglia from the solar plexus (right kidney: 53%, left kidney: 83%) and/or by the lumbar sympathetic chain (right kidney: 63%, left kidney: 60%). Both carried innervation to the kidneys but importantly also to other abdominal and pelvic organs, which can be accidentally denervated if the proximal renal artery is targeted for ablation. These novel anatomic insights may help guide future procedural treatment recommendations to increase the likelihood of safely reaching and destroying targeted nerves during renal denervation procedures.

scholarly journals Renal Outcome and New-Onset Renal and Extrarenal Dissections in Patients With Nontrauma Renal Artery Dissection Associated With Renal Infarction

Hypertension ◽  
2021 ◽  
Author(s):  
Anne-Laure Faucon ◽  
Guillaume Bobrie ◽  
Arshid Azarine ◽  
Elie Mousseaux ◽  
Tristan Mirault ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glomerular Filtration Rate ◽  
Renal Artery ◽  
Filtration Rate ◽  
Fibromuscular Dysplasia ◽  
Estimated Glomerular Filtration Rate ◽  
Arterial Disease ◽  
Artery Dissection ◽  
Renal Infarction ◽  
New Onset

We aimed to compare the characteristics of the patients with renal infarction related to nontrauma renal artery dissection (RAD) with versus without an underlying vascular disease and report long-term renal and vascular outcomes, as well as new-onset renal and extra-RADs. Data from 72 consecutive patients with RAD referred to our Hypertension Unit between 2000 and 2015 were analyzed. Radiological data, including a systematic brain-to-pelvis computed tomography angiography, were independently reviewed. Three main causes of RAD were identified at the initial work-up: fibromuscular dysplasia (n=16); dissecting or aneurysmal multisite arterial disease (n=21) not linked to any known vascular disease; and isolated RAD (n=24) without any other arterial lesion. At diagnosis, patients (median age 46 [interquartile range, 40–53] years, 70.5% males, 26.2% preexisting hypertension, 65.6% smokers) had a median blood pressure of 138 (125–152)/87 (78–97) mm Hg. Estimated glomerular filtration rate was 81 (66–95) mL/min per 1.73 m 2 and 18% had renal impairment. Patients were treated with antiplatelet drugs (65.6%), anticoagulant (3.3%). A total of 11.5% underwent angioplasty. No clinical or biological difference was observed between the 3 groups. After 51 (19–92) months follow-up, blood pressure was reduced by 13 (0–29)/9 (3–18) mm Hg; 11.5% of patients had estimated glomerular filtration rate <60 mL/min per 1.73 m 2 . RAD evolved toward healing (67.2%), aneurysmal dilation (24.6%), or stenosis (8.2%). New-onset RAD was as frequent in dissecting or aneurysmal multisite arterial disease (23.8%) than in fibromuscular dysplasia (25%) group, whereas de novo extrarenal dissection was 6-fold more frequent in dissecting or aneurysmal multisite arterial disease (38.1%) than in fibromuscular dysplasia (6.3%) group. No new event occurred in patients with an initial diagnosis of isolated RAD. Initial diagnostic accuracy using thorough systematic exhaustive explorations of arterial sites helps to stratify the risk of new-onset dissection and adapt monitoring accordingly.

scholarly journals Isolated acute renal infarction in an obese patient

2021 ◽  
Vol 6 (12) ◽  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Obese Patient ◽  
Left Kidney ◽  
Vascular Complications ◽  
Arterial Disease ◽  
Renal Infarction ◽  
Lower Pole ◽  
Segmental Artery

Background: Uncontrolled cardiovascular (CV) risk factors is been related to a higher incidence of atherosclerosis. Obesity itself could predispose to significant cardiac disease including arterial atheromatous leading to acute events. Case: A 46 years old obese patient who presented with left abdominal pain radiating to the left quadrant and left testicle. No significant abnormality was observed in the laboratories, but imaging showed left renal lower pole may be due to renal infarct (Figure 1), and CT-Angiography (CTA) of the abdomen showed infarction of the anterior two-thirds of the lower pole of the left kidney (Figure 2) secondary to occlusion of the supplying small inferior segmental artery and minimal atherosclerosis. Transthoracic Echocardiogram (TTE) showed a density in the LVOT may be artifact vs. calcification (Figure 3). A transesophageal echocardiogram (TEE) showed Grade III atherosclerotic changes of descending aorta (Figure 4), aortic arch, and a mobile plaque seen in the thoracic aorta. Conclusion: Cardiovascular risk factors have been associated with multiple vascular complications. Obesity as a single cardiovascular risk factor is associated with advanced arterial disease; our case is an example of an unstable atheromatous lesion causing thrombosis and ischemia in the kidney in a patient without another risk factor for thrombosis.

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