title: [Renal artery thrombosis and renal infarction, diagnostic and therapeutic difficulties--reports of two cases].
abstract: Renal artery thrombosis (RAT) is a rare condition, with a poor prognosis, which can lead to renal infarction (RI). RAT has both cardiogenic etiology (arrhythmia, endocarditis, valvular heart disease, coronary disease) and noncardiogenic etiology (renal artery injury and/or instrumentation, fibromuscular dysplasia, coagulation disorders, homocystinuria, cocaine intake). In 30% of cases RAT etiology remains undetermined and then it is labeled idiopathic RAT. Because of the absence of typical symptoms and abnormalities in laboratory tests as well as often ambiguous results of imaging scans, RAT frequently remains undiagnosed. Presently RAT treatment standards are lacking due to its being a rare disease, which renders making treatment decisions difficult. However, because of a high risk of developing its serious complication in the form of RI, it seems necessary to introduce patient-tailored treatment in each case. Two cases presented in this paper demonstrate diagnostic difficulties and the necessity to introduce personalized treatment. Case 1 concerns idiopathic RAT in which anticoagulation therapy was introduced. Case 2 describes cardiogenic RAT with renal artery stenosis treated interventionally, i.e., percutaneous transluminal angioplasty (PTA) combined with antiplatelet drugs. In both cases recanalization of the renal artery was successful and a stable renal function was achieved.
authors.forename: Beata
authors.initials: B
authors.lastname: Januszko-Giergielewicz
authors.forename: Monika
authors.initials: M
authors.lastname: Kubiak
authors.forename: Leszek
authors.initials: L
authors.lastname: Gromadziński
authors.forename: Emil
authors.initials: E
authors.lastname: Paszkowska
mesh_terms: D017130:Angioplasty; D000925:Anticoagulants / Q000627:therapeutic use; D006801:Humans; D007668:Kidney / Q000098:blood supply*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012078:Renal Artery Obstruction / Q000175:diagnosis* / Q000628:therapy*; D013927:Thrombosis / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors