Greenberg Sheldon, Jana Kundan, Janga Kalyana, Lee Meng-Hsun, Lockwood Mary
Division of Nephrology, Maimonides Medical Center, Brooklyn, New York, USA.
Nephron. 2025;149(1):11-17. doi: 10.1159/000541333. Epub 2024 Sep 9.
Acute renal infarction (ARI) is a relatively rare and underdiagnosed condition. Presenting symptoms are nonspecific, and imaging is the mainstay for diagnosis. This study attempts to characterize the profile of patients with ARI and identify possible risk factors.
All inpatients admitted with diagnosis of ARI between 2010 and 2022 were included in this single-center retrospective observational study. Patients with chronic renal infarction, iatrogenic causes, and without radiographic evidence of ARI were excluded. Clinical, laboratory, and radiological findings of patients were collected. Patients were grouped into three groups based on probable etiology: cardiovascular, hypercoagulable disorders, and idiopathic, and analyzed.
Eighty-five patients were included. Mean age of patients was 61.6 ± 17.54 years. Cardiovascular group had the highest number of patients (49.4%) of which atrial fibrillation was the most common etiology (59.5%). Malignancy was the most common etiology in the hypercoagulable disorder group (69.3%). Patients in the idiopathic group were significantly younger and had higher mean body mass index than the other 2 groups at presentation. Smokers had 9 times higher risk of renal infarction in cardiovascular group and 1.7 times higher risk in hypercoagulable when compared to the idiopathic group. 48.2% of patients developed renal infarction though they were on antiplatelets/anticoagulants.
ARI is a rare and often underdiagnosed condition that can have residual renal dysfunction. It is important to consider ARI as a differential especially in young patients with risk factors even if they are on anticoagulation medication.
急性肾梗死（ARI）是一种相对罕见且诊断不足的病症。其临床表现不具有特异性，影像学检查是诊断的主要依据。本研究旨在描述ARI患者的特征并确定可能的危险因素。
本单中心回顾性观察研究纳入了2010年至2022年间诊断为ARI的所有住院患者。排除患有慢性肾梗死、医源性病因以及无ARI影像学证据的患者。收集患者的临床、实验室和影像学检查结果。根据可能的病因将患者分为三组：心血管疾病组、高凝状态组和特发性组，并进行分析。
共纳入85例患者。患者的平均年龄为61.6±17.54岁。心血管疾病组的患者数量最多（49.4%），其中房颤是最常见的病因（59.5%）。恶性肿瘤是高凝状态组最常见的病因（69.3%）。特发性组患者在就诊时明显比其他两组年轻，平均体重指数更高。与特发性组相比，心血管疾病组吸烟者发生肾梗死的风险高9倍，高凝状态组高1.7倍。48.2%的患者尽管正在服用抗血小板/抗凝药物仍发生了肾梗死。
ARI是一种罕见且常被漏诊的病症，可能导致残余肾功能不全。即使患者正在接受抗凝治疗，对于有危险因素的年轻患者，尤其是要考虑将ARI作为鉴别诊断。
