Turina S, Mazzola G, Venturelli C, Valerio F, Dallera N, Kenou R, Sottini L, Maffeo D, Tardanico R, Faggiano P, Scolari F
Cattedra di Nefrologia, Università di Brescia, Brescia.
G Ital Nefrol. 2009 Mar-Apr;26(2):181-90.
Atheroembolic renal disease can be defined as renal failure due to occlusion of the renal arterioles by cholesterol crystal emboli usually dislodged from ulcerated atherosclerotic plaques of the aorta. Atheroembolic renal disease is part of multisystem disease, since the embolization usually involves other organ systems such as the gastrointestinal system, central nervous system, and lower extremities. The kidney is frequently involved because of the proximity of the renal arteries to the abdominal aorta, where erosion of atheromatous plaques is most likely to occur. Embolization may occur spontaneously or after angiographic procedures, vascular surgery, and anticoagulation. In the last decade, atheroembolic renal disease has become a recognizable cause of renal disease. An ante-mortem diagnosis of the disease is possible in a significant proportion of cases as long as the level of diagnostic suspicion is high. The disease can severely affect kidney and patient survival. Although no specific treatment has been proven efficacious, use of statins may be justifiable and such therapy would be a reasonable choice for future treatment trials.
动脉粥样硬化栓塞性肾病可定义为因胆固醇结晶栓子阻塞肾小动脉而导致的肾衰竭,这些栓子通常从主动脉的溃疡性动脉粥样硬化斑块脱落。动脉粥样硬化栓塞性肾病是多系统疾病的一部分,因为栓塞通常累及其他器官系统,如胃肠道系统、中枢神经系统和下肢。由于肾动脉靠近腹主动脉,动脉粥样硬化斑块最易在此处发生糜烂,所以肾脏经常受累。栓塞可能自发发生,也可能在血管造影术、血管手术及抗凝治疗后出现。在过去十年中,动脉粥样硬化栓塞性肾病已成为一种可识别的肾病病因。只要诊断怀疑度高,在相当比例的病例中可进行生前诊断。该疾病可严重影响肾脏及患者生存。虽然尚未证实有特效治疗方法,但使用他汀类药物可能合理,且这种治疗方法将是未来治疗试验的合理选择。