PMID- 25463344 OWN - NLM STAT- MEDLINE DCOM- 20151217 LR - 20150316 IS - 1615-5947 (Electronic) IS - 0890-5096 (Linking) VI - 29 IP - 3 DP - 2015 Apr TI - Long-term follow-up results of acute renal embolism after anticoagulation therapy. PG - 491-5 LID - S0890-5096(14)00665-7 [pii] LID - 10.1016/j.avsg.2014.09.028 [doi] AB - BACKGROUND: Acute renal embolism (ARE) is a rare cause of acute abdominal pain. However, there are only a few studies on the clinical course of ARE. We attempted to investigate the clinical manifestations and long-term follow-up results of ARE. METHODS: From September 2006 to August 2012, 47 patients, who were diagnosed with ARE by computed tomography (CT), were enrolled. Patient demographic and clinical data were retrospectively reviewed. For the long-term outcomes, change in the serum creatinine (s-Cr) level, change in renal infarction on follow-up CT, recurrent embolism, and dialysis-free survival were investigated. RESULTS: The mean age of patients was 61 years (range, 29-89 years), and 51% of the patients were men. All the patients presented with abdominal or flank pain. The sites of ARE were the right kidney in 57% of the patients, the left kidney in 36% of the patients, and both the kidneys in 6% of the patients. The infarction volume was less than 50% of renal volume in 54% of infarcted kidneys. Six patients had a concurrent infarction in other organs (3 cases of splenic infarction and 3 cases of cerebral infarction). Etiology of embolism was cardiogenic in 55% and idiopathic in 45%. Mean s-Cr level was 1.2 mg/dL (range, 0.6-3.7 mg/dL). s-Cr elevation >0.5 mg/dL was detected in 19% of patients during the follow-up (6 of 31 patients; mean duration, 31 months). Follow-up CT was performed in 23 patients (mean duration, 29 months). The infarcted lesions showed atrophic changes in all the cases except for 1 case. During the mean follow-up period of 41 months (1-118 months), recurrent embolism developed in 8 patients (6 cases of cerebral artery embolism, 1 case of superior mesenteric artery embolism, and 1 case of renal artery embolism). Dialysis was necessary in 1 patient, and dialysis-free survival rates were 91%, 82%, and 64% at 1 year, 3 years, and 5 years, respectively. CONCLUSIONS: Although ARE causes irreversible loss of renal mass, it rarely leads to end-stage renal disease or long-term mortality. Therefore, the treatment should focus on the prevention of subsequent embolism to other vital organs. CI - Copyright (c) 2015 Elsevier Inc. All rights reserved. FAU - Yun, Woo-Sung AU - Yun WS AD - Division of Transplantation and Vascular Surgery, Department of Surgery, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea. Electronic address: wsyun@me.com. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20141124 PL - Netherlands TA - Ann Vasc Surg JT - Annals of vascular surgery JID - 8703941 RN - 0 (Anticoagulants) RN - 0 (Biomarkers) RN - AYI8EX34EU (Creatinine) SB - IM MH - Abdominal Pain/etiology MH - Acute Pain/etiology MH - Adult MH - Aged MH - Aged, 80 and over MH - Anticoagulants/*therapeutic use MH - Biomarkers/blood MH - Creatinine/blood MH - Disease-Free Survival MH - Embolism/complications/diagnosis/*drug therapy MH - Female MH - Flank Pain/etiology MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Recurrence MH - Renal Artery Obstruction/complications/diagnosis/*drug therapy MH - Renal Dialysis MH - Retrospective Studies MH - Time Factors MH - Tomography, X-Ray Computed MH - Treatment Outcome EDAT- 2014/12/03 06:00 MHDA- 2015/12/19 06:00 CRDT- 2014/12/03 06:00 PHST- 2014/04/06 00:00 [received] PHST- 2014/08/10 00:00 [revised] PHST- 2014/09/22 00:00 [accepted] PHST- 2014/12/03 06:00 [entrez] PHST- 2014/12/03 06:00 [pubmed] PHST- 2015/12/19 06:00 [medline] AID - S0890-5096(14)00665-7 [pii] AID - 10.1016/j.avsg.2014.09.028 [doi] PST - ppublish SO - Ann Vasc Surg. 2015 Apr;29(3):491-5. doi: 10.1016/j.avsg.2014.09.028. Epub 2014 Nov 24.