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Thursday, July 8, 2010

CONSULT ROUND: ATHEROEMBOLIC DISEASE




RENAL ATHERO EMBOLIC DISEASE







We discussed Renal Athero embolic disease
We are referring is to Cholesterol Emboli: Key Take home points:
RISK FACTORS:
Severe vascular disease
Recent manipulation of large arteries ( angio, surgery) but some cases are without manipulation
Cardiac Cath
Age
Anticoagulation use ( coumadin, heparin)
Perhaps even Renal Artery Stenosis( could just be part of severe vascular disease)

Clinical/Lab Clues:
4-6 weeks post procedure rise in crt , and rapid
Hypocomplementemia
Eisonophilia and philuria
Usually a bland sediment in the urine but sometimes blood is noted
Extra renal atheroembolic signs ( cyanosis, gangrene, "blue toes", livedo reticularis with good pulses)
Hollenhorst Plaques on eye exam


2 comments:

  1. Two Important things to distinguish it from Contrast induced Nephrology.

    1. Waxing and Waning course
    2. Timing of creatinine rise.

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