title: Acute renal infarction: a single center experience.
abstract: BACKGROUND
  Acute renal infarction is a rare condition whose diagnosis is often delayed. Major risk factors include atrial fibrillation, valvular or ischemic heart disease, renal artery thrombosis/dissection and coagulopathy.
  
  
  METHODS
  We reviewed the medical records of 18 patients admitted to our Nephrology Department between 1999 and 2015 for acute renal infarction diagnosed by computed tomography. Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy was performed in some patients during follow-up to assess parenchymal lesions and estimate differential kidney function.
  
  
  RESULTS
  Mean age was 59.8 years. Major associated risk factors included hypertension (44 %), obesity (33 %), atrial fibrillation (28 %), peripheral vascular disease (17 %), smoking (17 %), prior thromboembolic event (11 %), diabetes (11 %), estroprogestinic therapy (11 %). Seventy-two percent of patients presented with flank pain. Mean serum creatinine was 1.2 ± 0.6 mg/dl. Acute kidney injury occurred as the initial manifestation in two patients. Patients were managed conservatively, with low molecular weight heparin (83 %) or aspirin (11 %). At the end of follow-up serum creatinine was 1.1 ± 0.3 mg/dl; one patient remained on chronic hemodialysis. 58 % of patients who underwent renal scintigraphy after a median of 8 months had a reduced contribution of the previously affected kidney to total renal function.
  
  
  CONCLUSIONS
  Risk factors associated with the development of chronic kidney disease following renal infarction are unknown. In our subjects, renal function remained stable in all but one patient who developed end stage renal disease. Further studies should focus on etiology and evolution of kidney function in patients with acute renal infarction.
authors.affiliation: Nephrology and Dialysis Unit, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154, Turin, Italy. paola.mesiano@gmail.com.
authors.forename: Paola
authors.initials: P
authors.lastname: Mesiano
authors.affiliation: Nephrology and Dialysis Unit, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154, Turin, Italy.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Rollino
authors.affiliation: Nephrology and Dialysis Unit, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154, Turin, Italy.
authors.forename: Giulietta
authors.initials: G
authors.lastname: Beltrame
authors.affiliation: Nephrology and Dialysis Unit, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154, Turin, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Ferro
authors.affiliation: Nephrology and Dialysis Unit, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154, Turin, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Quattrocchio
authors.affiliation: Nephrology and Dialysis Unit, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154, Turin, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Fenoglio
authors.affiliation: Nephrology and Dialysis Unit, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pozzato
authors.affiliation: Nephrology and Dialysis Unit, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154, Turin, Italy.
authors.forename: Pasqualina
authors.initials: P
authors.lastname: Cecere
authors.affiliation: Nephrology and Dialysis Unit, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154, Turin, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Forneris
authors.affiliation: Hematology Unit, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154, Turin, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Bazzan
authors.affiliation: Radiology, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154, Turin, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Macchia
authors.affiliation: Nephrology and Dialysis Unit, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154, Turin, Italy.|Center of Research on Immunopathology and Rare Diseases, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154, Turin, Italy.|University of Turin, Turin, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Roccatello
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003404:Creatinine / Q000097:blood; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D007238:Infarction / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D007668:Kidney / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D006495:Heparin, Low-Molecular-Weight; D003404:Creatinine
keywords: Acute kidney injury; Acute renal infarction; Renal scintigraphy; Single center study