Abstract
Background
The prevalence of acute renal infarction (ARI) in Japan remains unclear. We describe the clinical features and renal prognosis of ARI in Japanese patients.
Methods
This single-center, retrospective, observational study included 33 patients with newly diagnosed ARI (2009–2013). Their clinical features and long-term renal outcomes were evaluated.
Results
The prevalence of ARI among emergency room patients was 0.013 %. The incidence of ARI among in-patients was 0.003 % (mean age 71.9 ± 13.4 years; men 63 %). Enhanced computed tomography or renal isotope scans were obtained to diagnose ARI. ARI involved the left kidney in 70 %, right kidney in 18 %, and both kidneys in 12 % of patients. Four cases had splenic infarction, and 70 % of patients had atrial fibrillation. We noted abdominal or flank pain in 66 %, fever (>37.6 °C) in 36 %, and nausea/vomiting in 6 % of patients. The white blood cell count, and levels of lactate dehydrogenase and C-reactive protein peaked at 2–4 days after onset. Acute kidney injury due to ARI occurred in 76 % of patients. The estimated glomerular filtration rate decreased to ~70 % and recovered to ~80 % of the original value after 1 year. The mortality rates were 9 and 15 % at 1 month and 1 year, respectively.
Conclusions
We determined the prevalence of ARI among emergency room patients, its incidence among in-patients, and short-term and long-term mortality. The majority of ARI cases were of cardiac origin, and the others were due to trauma or systemic thrombotic disease. Clinicians should recognize ARI as a fatal arterial thrombotic disease.
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Huang CC, Lo HC, Huang HH, Kao WF, Yen DH, Wang LM, Huang CI, Lee CH. ED presentations of acute renal infarction. Am J Emerg Med. 2007;25:164–9.
Antopolsky M, Simanovsky N, Stalnikowicz R, Salameh S, Hiller N. Renal infarction in the ED: 10-year experience and review of the literature. Am J Emerg Med. 2012;30:1055–60.
Tsai SH, Chu SJ, Chen SJ, Fan YM, Chang WC, Wu CP, Hsu CW. Acute renal infarction: a 10-year experience. Int J Clin Pract. 2007;61:62–7.
Huang CC, Chen WL, Chen JH, Wu YL, Shiao CJ. Clinical characteristics of renal infarction in an Asian population. Ann Acad Med Singapore. 2008;37:416–20.
Bourgault M, Grimbert P, Verret C, Pourrat J, Herody M, Halimi JM, Karras A, Amoura Z, Jourde-Chiche N, Izzedine H, François H, Boffa JJ, Hummel A, Bernadet-Monrozies P, Fouque D, Canouï-Poitrine F, Lang P, Daugas E, Audard V. Acute renal infarction: a case series. Clin J Am Soc Nephrol. 2013;8:392–8.
Makino H, Nagataku Y. Renal infarction [in Japanese]. Nihon Naika Gakkai Zasshi. 1993;82:1802–6.
Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, Yamagata K, Tomino Y, Yokoyama H, Hishida A, Collaborators developing the Japanese equation for estimated GFR. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.
Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P, Acute Dialysis Quality Initiative workgroup. Acute renal failure definition, outcome measures, animal models, fluid therapy and information technology needs: the second international consensus conference of the acute dialysis quality initiative (ADQI) group. Crit Care. 2004;8:R204–12.
Paris B, Bobrie G, Rossignol P, Le Coz S, Chedid A, Plouin PF. Blood pressure and renal outcomes in patients with kidney infarction and hypertension. J Hypertens. 2006;24:1649.
Hoxie HJ, Coggin CB. Renal infarction: statistical study of two hundred and five cases and detailed report of an unusual case. Arch Intern Med. 1940;65:587.
Frost L, Engholm G, Johnsen S, Møller H, Henneberg EW, Husted S. Incident thromboembolism in the aorta and the renal, mesenteric, pelvic, and extremity arteries after discharge from the hospital with a diagnosis of atrial fibrillation. Arch Intern Med. 2001;161:272–6.
JCS Joint Working Group. Guidelines for pharmacotherapy of atrial fibrillation (JCS 2013). Circ J. 2014;78:1997–2021.
Takii T, Yasuda S, Takahashi J, Ito K, Shiba N, Shirato K, Shimokawa H, MIYAGI-AMI Study Investigators. Trends in acute myocardial infarction incidence and mortality over 30 years in Japan: report from the MIYAGI-AMI registry study. Circ J. 2010;74:93–100.
Nakatani D, Sakata Y, Suna S, Usami M, Matsumoto S, Shimizu M, Sumitsuji S, Kawano S, Ueda Y, Hamasaki T, Sato H, Nanto S, Hori M, Komuro I, Osaka Acute Coronary Insufficiency Study (OACIS) Investigators. Incidence, predictors, and subsequent mortality risk of recurrent myocardial infarction in patients following discharge for acute myocardial infarction. Circ J. 2013;77:439–46.
Acknowledgments
We thank the hospitals and clinics of the Ishinomaki region that cooperated with our research study. In addition, we thank Dr. Mariko Miyazaki for preparing the manuscript.
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Nagasawa, T., Matsuda, K., Takeuchi, Y. et al. A case series of acute renal infarction at a single center in Japan. Clin Exp Nephrol 20, 411–415 (2016). https://doi.org/10.1007/s10157-015-1168-1
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DOI: https://doi.org/10.1007/s10157-015-1168-1