genitourinary disorders
Renal Atheroembolism
Diagnosis of Renal Atheroembolism
Clinical suspicion Sometimes, renal biopsy Location of source of emboli Diagnosis is suggested by worsening renal function in a patient with recent manipulation of the aorta, particularly if there are signs of atheroemboli. Differential diagnosis includes contrast-induced and drug-induced nephropathy. If suspicion of atheroembolism remains high, percutaneous renal biopsy is done; it has a sensitivity of about 75%. Diagnosis is important because there may be treatable causes of emboli in the absence of vascular obstruction. Cholesterol crystals in the emboli dissolve during tissue fixation, leaving pathognomonic biconcave, needle-shaped clefts in the occluded vessel. Sometimes skin, muscle, or gastrointestinal biopsy can provide the same information and indirectly help establish the diagnosis. Blood and urine tests can confirm the diagnosis of Acute Kidney Injury (AKI) or If renal or systemic emboli recur and their source is unclear, transesophageal echocardiography is done to detect atheromatous lesions in the ascending and thoracic aorta and cardiac sources of emboli; dual helical CT may help characterize the ascending aorta and aortic arch. 