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Acute arterial occlusion - kidney

Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery

Acute arterial occlusion of the kidney is a sudden, severe blockage of the artery that supplies blood to the kidney.

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Kidney anatomy
Kidney - blood and urine flow
Kidney blood supply

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Causes

The kidneys need a good blood supply. The main artery to the kidney is called the renal artery. Reduced blood flow through the renal artery can hurt kidney function. A complete blockage of blood flow to the kidney can often result in permanent kidney failure.

Acute arterial occlusion of the renal artery can occur after injury or trauma to the abdomen, side, or back. Blood clots that travel through the bloodstream (emboli) can lodge in the renal artery. Pieces of plaque from the walls of the arteries can come loose (on their own or during a procedure). This debris can block the main kidney artery or one of the smaller vessels.

The risk of renal artery blockages increases in people who have certain heart disorders, which make them likely to form blood clots. These include mitral stenosis and atrial fibrillation.

A narrowing of the renal artery is called renal artery stenosis. This condition increases the risk of a sudden blockage.

Symptoms

You may not have symptoms when one kidney does not function because the second kidney can filter the blood. However, high blood pressure (hypertension) may come on suddenly and be difficult to control.

If your other kidney is not working fully, blockage of the renal artery may cause symptoms of acute kidney failure. Other symptoms of acute arterial occlusion of the renal artery include:

Note: There may be no pain. Pain, if it is present, most often develops suddenly.

Exams and Tests

The health care provider will not be able to identify the problem with just an exam unless you have developed kidney failure.

Tests you may need include:

Treatment

Often, people do not need treatment. Blood clots may get better on their own over time.

You may have treatment to open the artery if the blockage is discovered quickly or it is affecting the only working kidney. Treatment to open the artery may include:

You may need temporary dialysis to treat acute kidney failure. Medicines to lower cholesterol may be needed if the blockage is due to clots from plaque buildup in the arteries.

Outlook (Prognosis)

Damage caused by arterial occlusion may go away. However, in most cases, it is permanent.

If only one kidney is affected, the healthy kidney may take over filtering the blood and producing urine. If you have only one working kidney, arterial occlusion leads to acute kidney failure. This can develop into chronic kidney failure.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Call your provider if:

Get emergency medical help right away if you have symptoms of arterial occlusion and have only one working kidney.

Prevention

In many cases, the disorder is not preventable. The most important way to reduce your risk is to stop smoking.

People at risk for developing blood clots may need to take anti-clotting medicines. Taking steps to control diseases related to atherosclerosis (hardening of the arteries) may reduce your risk.

Related Information

Renal
High blood pressure - adults
Acute kidney failure
Blood clots
Malignant hypertension
End-stage kidney disease

References

DuBose TD, Santos RM. Vascular disorders of the kidney. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 125.

Myers DJ, Myers SI. System complications: renal. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 44.

Ruggenenti P, Cravedi P, Remuzzi G. Microvascular and macrovascular diseases of the kidney. In: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. Brenner and Rector's The Kidney. 10th ed. Philadelphia, PA: Elsevier; 2016:chap 35.

Watson RS, Cogbill TH. Atherosclerotic renal artery stenosis. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 12th ed. Philadelphia, PA: Elsevier; 2017:1041-1047.

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Review Date: 4/15/2019  

Reviewed By: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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