Renal infarction is the necrosis of renal tissue as the result of ischemic injury to the kidney. This occurs most commonly due to thromboemboli, often cardioembolic in nature or due to in situ thrombosis as may occur in the setting of injury to the renal artery or due to a hypercoagulable state.

Atrial fibrillation is the most common cause overall, but infectious endocarditis, renal artery occlusion following aortic or renal interventions, polyarteritis nodosa, trauma, underlying hypercoagulable states, and cocaine use are other etiologies.

Renal infarction is felt to be a rare condition with incidence varying based on study: 1.4% in autopsy studies and 0.007% based on emergency department data. However, it is also an underrecognized condition and often missed.

Symptoms often mimic other renal pathology, including acute onset of flank pain or abdominal pain, hematuria, and occasionally fever or vomiting; thus, diagnosis can be delayed. Physical examination findings include acute hypertension and, rarely, other signs of extrarenal embolization, including focal neurologic deficits.