genitourinary disorders
Renal Atheroembolism
Introduction
Renal atheroembolism is occlusion of renal arterioles by atherosclerotic emboli, causing progressive chronic kidney disease. It results from rupture of atheromatous plaques. Symptoms are those of renal failure; symptoms and signs of widespread arterial embolic disease may be present. Diagnosis is by renal biopsy. Long-term prognosis is usually poor. Treatment aims to prevent further embolization. Atheromatous plaque rupture usually results from manipulation of the aorta or other large arteries during vascular surgery, angioplasty, or arteriography. Spontaneous plaque rupture, which occurs most often in patients who have diffuse erosive atherosclerosis or who are being treated with anticoagulants or fibrinolytics, is rare. Atheroemboli tend to cause incomplete occlusion with secondary ischemic atrophy rather than renal infarction. A foreign body immune reaction often follows embolization, leading to continued deterioration in renal function for 3 to 8 weeks. Acute renal impairment may also result from massive or recurrent episodes of embolization. 