Clinical Characteristics and Outcomes of Renal Infarction

Yun Kuy Oh, Chul Woo Yang, Yong Lim Kim, Shin-Wook Kang, Cheol Whee Park, Yon Su Kim, Eun Young Lee, Byoung Geun Han, Sang Ho Lee, Su Hyun Kim, Hajeong Lee, Chun Soo Lim

Research output: Contribution to journalArticle

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Abstract

Background Renal infarction is a rare condition resulting from an acute disruption of renal blood flow, and the cause and outcome of renal infarction are not well established. Study Design Case series. Setting & Participants 438 patients with renal infarction in January 1993 to December 2013 at 9 hospitals in Korea were included. Renal infarction was defined by radiologic findings that included single or multiple wedge-shaped parenchymal perfusion defects in the kidney. Predictor Causes of renal infarction included cardiogenic (n = 244 [55.7%]), renal artery injury (n = 33 [7.5%]), hypercoagulable (n = 29 [6.6%]), and idiopathic (n = 132 [30.1%]) factors. Outcomes We used recurrence, acute kidney injury (AKI; defined as creatinine level increase ≥ 0.3 mg/dL within 48 hours or an increase to 150% of baseline level within 7 days during the sentinel hospitalization), new-onset estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 (for >3 months after renal infarction in the absence of a history of decreased eGFR), end-stage renal disease (ESRD; receiving hemodialysis or peritoneal dialysis because of irreversible kidney damage), and mortality as outcome metrics. Results Treatment included urokinase (n = 19), heparin (n = 342), warfarin (n = 330), and antiplatelet agents (n = 157). 5% of patients died during the initial hospitalization. During the median 20.0 (range, 1-223) months of follow-up, 2.8% of patients had recurrent infarction, 20.1% of patients developed AKI, 10.9% of patients developed new-onset eGFR < 60 mL/min/1.73 m2, and 2.1% of patients progressed to ESRD. Limitations This was a retrospective study; it cannot clearly determine the specific causal mechanism for certain patients or provide information about the causes of mortality. 16 patients were excluded from the prognostic analysis. Conclusions Cardiogenic origins were the most important causes of renal infarction. Despite aggressive treatment, renal infarction can lead to AKI, new-onset eGFR < 60 mL/min/1.73 m2, ESRD, and death.

Original languageEnglish
Pages (from-to)243-250
Number of pages8
JournalAmerican Journal of Kidney Diseases
Volume67
Issue number2
DOIs
Publication statusPublished - 2016 Feb 1

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Infarction
Kidney
Glomerular Filtration Rate
Chronic Kidney Failure
Hospitalization
Mortality
Renal Circulation
Platelet Aggregation Inhibitors
Urokinase-Type Plasminogen Activator
Peritoneal Dialysis
Renal Artery
Warfarin
Korea
Acute Kidney Injury
Renal Dialysis
Heparin
Creatinine
Retrospective Studies
Perfusion
Recurrence

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Oh, Y. K., Yang, C. W., Kim, Y. L., Kang, S-W., Park, C. W., Kim, Y. S., ... Lim, C. S. (2016). Clinical Characteristics and Outcomes of Renal Infarction. American Journal of Kidney Diseases, 67(2), 243-250. https://doi.org/10.1053/j.ajkd.2015.09.019
Oh, Yun Kuy ; Yang, Chul Woo ; Kim, Yong Lim ; Kang, Shin-Wook ; Park, Cheol Whee ; Kim, Yon Su ; Lee, Eun Young ; Han, Byoung Geun ; Lee, Sang Ho ; Kim, Su Hyun ; Lee, Hajeong ; Lim, Chun Soo. / Clinical Characteristics and Outcomes of Renal Infarction. In: American Journal of Kidney Diseases. 2016 ; Vol. 67, No. 2. pp. 243-250.
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Oh, YK, Yang, CW, Kim, YL, Kang, S-W, Park, CW, Kim, YS, Lee, EY, Han, BG, Lee, SH, Kim, SH, Lee, H & Lim, CS 2016, 'Clinical Characteristics and Outcomes of Renal Infarction', American Journal of Kidney Diseases, vol. 67, no. 2, pp. 243-250. https://doi.org/10.1053/j.ajkd.2015.09.019

Clinical Characteristics and Outcomes of Renal Infarction. / Oh, Yun Kuy; Yang, Chul Woo; Kim, Yong Lim; Kang, Shin-Wook; Park, Cheol Whee; Kim, Yon Su; Lee, Eun Young; Han, Byoung Geun; Lee, Sang Ho; Kim, Su Hyun; Lee, Hajeong; Lim, Chun Soo.

In: American Journal of Kidney Diseases, Vol. 67, No. 2, 01.02.2016, p. 243-250.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical Characteristics and Outcomes of Renal Infarction

AU - Oh, Yun Kuy

AU - Yang, Chul Woo

AU - Kim, Yong Lim

AU - Kang, Shin-Wook

AU - Park, Cheol Whee

AU - Kim, Yon Su

AU - Lee, Eun Young

AU - Han, Byoung Geun

AU - Lee, Sang Ho

AU - Kim, Su Hyun

AU - Lee, Hajeong

AU - Lim, Chun Soo

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Background Renal infarction is a rare condition resulting from an acute disruption of renal blood flow, and the cause and outcome of renal infarction are not well established. Study Design Case series. Setting & Participants 438 patients with renal infarction in January 1993 to December 2013 at 9 hospitals in Korea were included. Renal infarction was defined by radiologic findings that included single or multiple wedge-shaped parenchymal perfusion defects in the kidney. Predictor Causes of renal infarction included cardiogenic (n = 244 [55.7%]), renal artery injury (n = 33 [7.5%]), hypercoagulable (n = 29 [6.6%]), and idiopathic (n = 132 [30.1%]) factors. Outcomes We used recurrence, acute kidney injury (AKI; defined as creatinine level increase ≥ 0.3 mg/dL within 48 hours or an increase to 150% of baseline level within 7 days during the sentinel hospitalization), new-onset estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 (for >3 months after renal infarction in the absence of a history of decreased eGFR), end-stage renal disease (ESRD; receiving hemodialysis or peritoneal dialysis because of irreversible kidney damage), and mortality as outcome metrics. Results Treatment included urokinase (n = 19), heparin (n = 342), warfarin (n = 330), and antiplatelet agents (n = 157). 5% of patients died during the initial hospitalization. During the median 20.0 (range, 1-223) months of follow-up, 2.8% of patients had recurrent infarction, 20.1% of patients developed AKI, 10.9% of patients developed new-onset eGFR < 60 mL/min/1.73 m2, and 2.1% of patients progressed to ESRD. Limitations This was a retrospective study; it cannot clearly determine the specific causal mechanism for certain patients or provide information about the causes of mortality. 16 patients were excluded from the prognostic analysis. Conclusions Cardiogenic origins were the most important causes of renal infarction. Despite aggressive treatment, renal infarction can lead to AKI, new-onset eGFR < 60 mL/min/1.73 m2, ESRD, and death.

AB - Background Renal infarction is a rare condition resulting from an acute disruption of renal blood flow, and the cause and outcome of renal infarction are not well established. Study Design Case series. Setting & Participants 438 patients with renal infarction in January 1993 to December 2013 at 9 hospitals in Korea were included. Renal infarction was defined by radiologic findings that included single or multiple wedge-shaped parenchymal perfusion defects in the kidney. Predictor Causes of renal infarction included cardiogenic (n = 244 [55.7%]), renal artery injury (n = 33 [7.5%]), hypercoagulable (n = 29 [6.6%]), and idiopathic (n = 132 [30.1%]) factors. Outcomes We used recurrence, acute kidney injury (AKI; defined as creatinine level increase ≥ 0.3 mg/dL within 48 hours or an increase to 150% of baseline level within 7 days during the sentinel hospitalization), new-onset estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 (for >3 months after renal infarction in the absence of a history of decreased eGFR), end-stage renal disease (ESRD; receiving hemodialysis or peritoneal dialysis because of irreversible kidney damage), and mortality as outcome metrics. Results Treatment included urokinase (n = 19), heparin (n = 342), warfarin (n = 330), and antiplatelet agents (n = 157). 5% of patients died during the initial hospitalization. During the median 20.0 (range, 1-223) months of follow-up, 2.8% of patients had recurrent infarction, 20.1% of patients developed AKI, 10.9% of patients developed new-onset eGFR < 60 mL/min/1.73 m2, and 2.1% of patients progressed to ESRD. Limitations This was a retrospective study; it cannot clearly determine the specific causal mechanism for certain patients or provide information about the causes of mortality. 16 patients were excluded from the prognostic analysis. Conclusions Cardiogenic origins were the most important causes of renal infarction. Despite aggressive treatment, renal infarction can lead to AKI, new-onset eGFR < 60 mL/min/1.73 m2, ESRD, and death.

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