Renal Infarction: Symptoms, Diagnosis, and Care

Q: Renal Infarction: Symptoms, Diagnosis, and Care

Hello： Renal vascular embolism (renal stroke) should be treated based on the underlying causes (such as arrhythmias, coagulation disorders, etc.) to prevent recurrence. <br>The following are general daily life precautions to consider： <br>1. <br>Take medications as prescribed by

Renal stroke

On November 15, 2004, I went to the emergency department of Yuan Sheng Hospital in Yuanlin Township, Changhua County, due to unexplained left lower abdominal pain.
At that time, X-rays and urinalysis were performed, and the diagnosis suggested possible kidney stones or other causes.
The doctor prescribed medication and administered pain relief injections, after which I returned home to rest.
However, the left lower abdominal pain did not subside.
In the afternoon of the 15th, I sought medical attention again at Dr.
Huang Shih-Long's clinic in Yuanlin Township.
Dr.
Huang performed an ultrasound and prescribed medication, and subsequently referred me to Changhua Christian Hospital.
I arrived at Changhua Christian Hospital's emergency department around 6 PM on the 15th.
Before 10 PM, various tests including pain management, X-rays, blood tests, and a CT scan were conducted.
The emergency physician explained the CT scan results and preliminary diagnosis, which indicated possible twisting of the intestines or other issues.
The doctor suggested that a colonoscopy might provide further insight and treatment, but the worst-case scenario would involve surgery.
After further examination, the doctor found that the intestines were normal, but the left lower abdominal pain persisted, radiating to the left lower back.
The physician performing the colonoscopy reviewed the CT images and discovered that approximately one-quarter of the left kidney was in a necrotic state due to vascular embolism.

Since the colonoscopy physician was not well-versed in kidney issues, my case was referred to a nephrologist.
However, according to the doctors at Changhua Christian Hospital, the nephrology department refused to take my case (the specific individual who declined should be identifiable through consultation records; I cannot speculate or name anyone).
Hearing this was like a bolt from the blue; it was shocking that a doctor would refuse to treat a patient in pain and fighting for their life, which seemed to disregard medical ethics.

Later, through various channels and connections, my family decided to transfer me to Taichung Veterans General Hospital for treatment.
On the morning of November 17, 2004, I was transferred to Taichung Veterans General Hospital.
Upon arrival, Dr.
Wu Ming-Ju from the nephrology department assessed my condition.
Based on the referral information, Dr.
Wu promptly admitted me and initiated all necessary tests and treatments.
However, due to the delay, the necrotic portion of the kidney could not be revascularized (despite angiography) and was allowed to naturally atrophy.
I was discharged on November 24, 2004.
I sincerely ask your hospital, based on your experience, what medications or treatments should I take for recovery from my symptoms (renal infarction), and how can I care for the remaining healthy kidney? What daily life precautions should I take? Thank you.

Gao, 40~49 year old female. Ask Date: 2004/12/02

Dr. Yang Zhangzhi reply Urology

Hello: Renal vascular embolism (renal stroke) should be treated based on the underlying causes (such as arrhythmias, coagulation disorders, etc.) to prevent recurrence.
The following are general daily life precautions to consider:
1.
Take medications as prescribed by your physician; do not purchase or take medications indiscriminately, as this can harm kidney function.

2.
Maintain a balanced diet; avoid overeating and excessive intake of protein and sodium, as these can increase the burden on the kidneys.

3.
Drink plenty of water; do not hold urine for too long, as this can promote bacterial growth in the bladder.
Bacteria can potentially ascend through the ureters and infect the kidneys.
Adequate hydration and sufficient urine output can also help prevent kidney stones.
Primarily drink plain water and pay attention to the quality of drinking water.

4.
Prevent diabetes and hypertension; those already diagnosed should manage their conditions and continue regular monitoring.

5.
Regularly monitor kidney function; if any abnormalities are detected during examinations, please discuss them with a nephrologist for further evaluation and follow-up.

Reply Date: 2004/12/02

More Info

Renal infarction, often referred to as "renal stroke," occurs when there is a blockage in the blood supply to the kidney, leading to tissue death (necrosis) due to a lack of oxygen and nutrients. This condition can arise from various causes, including embolism (a blood clot that travels from another part of the body), thrombosis (a clot that forms in the renal artery), or other vascular issues. Understanding the symptoms, diagnosis, and care for renal infarction is crucial for effective management and recovery.

Symptoms of Renal Infarction
The symptoms of renal infarction can vary depending on the extent of the infarction and the underlying cause. Common symptoms include:
1. Flank Pain: Patients often experience sudden, severe pain in the flank or lower back, which may radiate to the abdomen.

2. Hematuria: Blood in the urine can occur due to damage to the renal tissue.

3. Nausea and Vomiting: These symptoms may arise due to pain or as a response to the body's stress.

4. Fever: In some cases, an infection may accompany the infarction, leading to fever.

5. Hypertension: High blood pressure may develop as the body attempts to compensate for reduced kidney function.

Diagnosis
Diagnosis of renal infarction typically involves a combination of imaging studies and laboratory tests:
1. Ultrasound: This can help identify abnormalities in kidney structure and blood flow.

2. CT Scan: A CT angiogram is often the gold standard for diagnosing renal infarction, as it provides detailed images of blood vessels and can show areas of reduced blood flow.

3. MRI: In some cases, MRI may be used to assess renal blood flow and tissue viability.

4. Blood Tests: Elevated levels of creatinine and blood urea nitrogen (BUN) can indicate impaired kidney function.

Care and Management
Management of renal infarction focuses on addressing the underlying cause and supporting kidney function. Here are some key aspects of care:
1. Medication: Depending on the cause, anticoagulants may be prescribed to prevent further clot formation. If an embolism is identified, thrombolytic therapy may be considered to dissolve the clot.

2. Monitoring: Regular monitoring of kidney function through blood tests is essential to assess recovery and detect any further complications.

3. Hydration: Maintaining adequate hydration is crucial for kidney health. Patients should be encouraged to drink plenty of fluids unless contraindicated.

4. Dietary Modifications: A balanced diet low in sodium and protein may help reduce the workload on the kidneys. Consulting with a dietitian can provide personalized dietary recommendations.

5. Follow-Up Care: Regular follow-up appointments with a nephrologist are important for ongoing assessment of kidney function and management of any chronic conditions that may contribute to renal infarction.

Lifestyle Considerations
To support kidney health and prevent future incidents, patients should consider the following lifestyle modifications:
1. Avoiding Nephrotoxic Substances: Certain medications and substances can harm the kidneys. Always consult a healthcare provider before starting new medications.

2. Managing Chronic Conditions: Conditions such as hypertension and diabetes should be well-managed to reduce the risk of kidney damage.

3. Regular Exercise: Engaging in regular physical activity can improve overall health and support cardiovascular function, which is vital for kidney health.

4. Routine Check-Ups: Regular health check-ups can help detect any potential issues early, allowing for timely intervention.

In conclusion, renal infarction is a serious condition that requires prompt diagnosis and management. Understanding the symptoms, diagnostic methods, and care strategies can significantly impact recovery and long-term kidney health. If you have experienced renal infarction, it is essential to work closely with your healthcare team to develop a comprehensive care plan tailored to your needs.

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