American Journal of Kidney Diseases

Clinical Characteristics and Outcomes of Renal Infarction

Published:November 03, 2015DOI:


      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.


      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.


      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.


      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.


      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.


      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.

      Index Words

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        • Bae E.J.
        • Hwang K.
        • Jang H.N.
        • et al.
        A retrospective study of short- and long-term effects on renal function after acute renal infarction.
        Ren Fail. 2014; 36: 1385-1389
        • Lessman R.K.
        • Johnson S.F.
        • Coburn J.W.
        • Kaufman J.J.
        Renal artery embolism clinical features and long-term follow-up of 17 cases.
        Ann Intern Med. 1978; 89: 477-482
        • 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: 1055-1060
        • Bourgault M.
        • Grimbert P.
        • Verret C.
        • et al.
        Acute renal infarction: a case series.
        Clin J Am Soc Nephrol. 2013; 8: 392-398
        • Korzets Z.
        • Plotkin E.
        • Bernheim J.
        • Zissin R.
        The clinical spectrum of acute renal infarction.
        Isr Med Assoc J. 2002; 4: 781-784
        • Bolderman R.
        • Oyen R.
        • Verrijcken A.
        • Knockaert D.
        • Vanderschueren S.
        Idiopathic renal infarction.
        Am J Med. 2006; 119: 356.e9-356.e12
        • Huang C.C.
        • Lo H.C.
        • Huang H.H.
        • et al.
        ED presentations of acute renal infarction.
        Am J Emerg Med. 2007; 25: 164-169
        • Hazanov N.
        • Somin M.
        • Attali M.
        • et al.
        Acute renal embolism. Forty-four cases of renal infarction in patients with atrial fibrillation.
        Medicine (Baltimore). 2004; 83: 292-299
        • Domanovits H.
        • Paulis M.
        • Nikfardjam M.
        • et al.
        Acute renal infarction. Clinical characteristics of 17 patients.
        Medicine (Baltimore). 1999; 78: 386-394
        • Lumerman J.H.
        • Hom D.
        • Eiley D.
        • Smith A.D.
        Heightened suspicion and rapid evaluation with CT for early diagnosis of partial renal infarction.
        J Endourol. 1999; 13: 209-214
        • Wong W.S.
        • Moss A.A.
        • Federle M.P.
        • Cochran S.T.
        • London S.S.
        Renal infarction: CT diagnosis and correlation between CT findings and etiologies.
        Radiology. 1984; 150: 201-205
        • Lin W.L.
        • Seak C.J.
        • Wu J.Y.
        • Weng Y.M.
        • Chen H.C.
        Risk factors for development of chronic kidney disease following renal infarction: retrospective evaluation of emergency room patients from a single center.
        PloS One. 2014; 9: e98880
        • Levey A.S.
        • Stevens L.A.
        • Schmid C.H.
        • et al.
        A new equation to estimate glomerular filtration rate.
        Ann Intern Med. 2009; 150: 604-612
        • Levey A.S.
        • Coresh J.
        • Greene T.
        • et al.
        Expressing the Modification of Diet in Renal Disease Study equation for estimating glomerular filtration rate with standardized serum creatinine values.
        Clin Chem. 2007; 53: 766-772
        • Skali H.
        • Uno H.
        • Levey A.S.
        • Inker L.A.
        • Pfeffer M.A.
        • Solomon S.D.
        Prognostic assessment of estimated glomerular filtration rate by the new Chronic Kidney Disease Epidemiology Collaboration equation in comparison with the Modification of Diet in Renal Disease Study equation.
        Am Heart J. 2011; 162: 548-554
        • Schwartz G.J.
        • Brion L.P.
        • Spitzer A.
        The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents.
        Pediatr Clin North Am. 1987; 34: 571-590
        • Kidney Disease Improving Global Outcomes (KDIGO)
        KDIGO clinical practice guideline for a acute kidney injury.
        Kidney Int Suppl. 2012; 1: 1-138
        • Frost L.
        • Engholm G.
        • Johnsen S.
        • Moller H.
        • Henneberg E.W.
        • 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: 272-276