Renal artery atheroembolism
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.
I74.9 – Embolism and thrombosis of unspecified artery
95580006 – Renal artery embolism
Differential Diagnosis & Pitfalls
- Acute interstitial nephritis
- Contrast-induced nephropathy – Typically the time course of acute kidney injury in this case would be within 72 hours of the contrast exposure, whereas renal artery atheroembolism typically has a delayed onset of injury.
- Volume-responsive acute kidney injury
- Acute tubular necrosis
- Cardiorenal syndrome