Caused by dislodged fragments of atherosclerotic plaque embolizing to the renal arteries, this is an infrequent cause of subacute kidney injury. The most common etiology is an iatrogenic event, such as cardiac angiography, cardiac surgery, or anticoagulation in the setting of atherosclerosis.

Clinical symptoms are the same as those that present with acute or chronic renal failure with uremia. Abdominal pain, nausea, and vomiting may occur due to arterial microcirculation of abdominal organs. Blindness and yellow retinal plaque formation (Hollenhorst plaques) can occur due to retinal arteriolar emboli. Clinical signs of peripheral embolism may be present, such as gangrene, livedo reticularis, and painful muscle nodules.

Treatment involves addressing the source of emboli (when possible), controlling hypertension, and managing fluids and electrolytes. Some patients may require renal replacement therapy initially.

Patients with renal artery atheroembolism usually have a poor long-term prognosis.