Vidt D G
Department of Nephrology/Hypertension, Cleveland Clinic Foundation, Ohio 44195, USA.
Annu Rev Med. 1997;48:375-85. doi: 10.1146/annurev.med.48.1.375.
Cholesterol embolization (CE), usually occurring in males in their sixth or seventh decade of life, can affect multiple organ systems, including the kidney. Interventive diagnostic procedures and aortic surgery greatly increase the risk of CE. Rapid or insidious progression of renal failure in association with surgical or diagnostic radiologic procedures should suggest this diagnosis. Progressive renal insufficiency in older patients with generalized arterial disease should suggest ischemic nephropathy secondary to bilateral renal artery stenosis, renal CE, or both. Recent worsening of hypertension is characteristic of either diagnosis. A number of clinical conditions can simulate renal CE, and final differentiation may be possible only by renal biopsy. Aggressive, supportive management of renal CE is warranted because renal function may stabilize and, in a limited number of cases, may even improve.
胆固醇栓塞（CE）通常发生在60或70多岁的男性中，可影响包括肾脏在内的多个器官系统。介入性诊断程序和主动脉手术会大大增加CE的风险。与外科手术或诊断性放射学程序相关的肾衰竭快速或隐匿进展应提示该诊断。患有全身性动脉疾病的老年患者出现进行性肾功能不全应提示继发于双侧肾动脉狭窄、肾CE或两者的缺血性肾病。高血压近期恶化是这两种诊断的特征。许多临床情况可模拟肾CE，最终可能只有通过肾活检才能鉴别。鉴于肾功能可能稳定，且在少数情况下甚至可能改善，因此对肾CE进行积极的支持性治疗是必要的。
