Varanasi U R, Moorthy A V, Beirne G J
J Am Geriatr Soc. 1979 Sep;27(9):407-9. doi: 10.1111/j.1532-5415.1979.tb01677.x.
An 86-year-old man with previous normal renal function was hospitalized because of renal insufficiency. He had a long history of atherosclerotic heart disease, mild hypertension and pulmonary embolism, requiring anticoagulant therapy. In view of the normal-sized kidneys and absence of casts in the urinary sediment, a diagnosis of atheroembolic renal disease was made. The patient's renal function deteriorated, but he refused hemodialysis. Death occurred within a few weeks. At autopsy, severe aortic atherosclerosis was observed and atheroembolic renal disease was confirmed as the cause of renal failure. Occasionally, renal failure can be the sole manifestation of spontaneous atheroembolic disease. This possibility should be considered if the physician is called upon to establish the diagnosis when renal insufficiency develops in atherosclerotic patients.
一名既往肾功能正常的86岁男性因肾功能不全入院。他有长期的动脉粥样硬化性心脏病、轻度高血压和肺栓塞病史，需要抗凝治疗。鉴于肾脏大小正常且尿沉渣中无管型，诊断为动脉粥样硬化栓塞性肾病。患者肾功能恶化，但拒绝血液透析。几周内死亡。尸检时，观察到严重的主动脉粥样硬化，动脉粥样硬化栓塞性肾病被确认为肾衰竭的原因。偶尔，肾衰竭可能是自发性动脉粥样硬化栓塞性疾病的唯一表现。当动脉粥样硬化患者出现肾功能不全需要医生进行诊断时，应考虑这种可能性。
