Atheroembolic renal disease

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Male urinary system

Renal disease - atheroembolic; Cholesterol embolization syndrome; Atheroemboli - renal; Atherosclerotic disease - renal

AERD may not have any symptoms. However, it can cause the following:

• Foot pain, ulcers on the feet, or “blue toes” (due to decreased blood flow to the feet and toes)
• Pain in the abdomen, nausea or vomiting (due to decreased blood flow to the intestine)
• Pancreatitis (inflammation of the pancreas) or hepatitis (inflammation of the liver), although these are rare
• Strokes or blindness
• Flank pain and blood in the urine (rare)
• Uncontrolled high blood pressure

Kidney failure may result in the following:

• Nausea or vomiting
• Loss of appetite
• Weight loss
• Decreased or no urine output
• Swelling
• Decrease in sensation
• Skin pigment changes
• Dry itchy skin
• Drowsiness, confusion, lethargy

An examination may show swelling of the whole body. Examination of the eyes may show particles in the small arteries of the retina. Evidence of fluid overload may develop if kidney failure is present, including abnormal sounds when listening to the heart and lungs with a stethoscope. A loud whooshing sound called a bruit, for example, may be heard over the aorta or renal artery.

Blood pressure may be elevated, and the patient may have a history of hard-to-control high blood pressure. There may be multiple ulcers of the skin of the lower feet.

These tests help diagnose the disorder:

• Blood, protein, eosinophils, or other abnormality in a urinalysis.
• CBC abnormal (eosinophilia, thrombocytopenia ).
• Serum complement may be low.
• Serum lipids may be high.
• Accumulation of nitrogen wastes in the blood if kidney failure develops:
  • BUN elevated.
  • Creatinine elevated.
• Increased potassium or other abnormality in serum chemistry (chem-7 or chem-20 ).
• A kidney or abdominal ultrasound, abdominal CT scan, abdominal MRI, or abdominal x-ray may be abnormal. Medical dyes or special techniques may be used to enhance the images, such as in magnetic resonance angiography.
• Renal arteriography may show blockage.
• Kidney biopsy or biopsy of other suspect tissue may show changes indicating atheroembolic disease.

Review Date: 06/13/2005
Reviewed By: Debbie Cohen, M.D., Renal and Electrolyte Division, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.