Acute renal infarction: A 12 year retrospective analysis

Introduction: Acute renal infarction (ARI) is a relatively rare and underdiagnosed condition. Presenting symptoms are non-specific and imaging is the mainstay for diagnosis. This study attempts to characterize the profile of patients with acute renal infarction and identify possible risk factors. Methods: All inpatients admitted with diagnosis of ARI between 2010 to 2022 were included in this single center retrospective observational study. Patients with chronic renal infarction, iatrogenic causes and without radiographic evidence of acute renal infarction were excluded. Clinical, laboratory and radiological findings of patients were collected. Patients were grouped into three groups based of cardiovascular, hypercoagulable disorders and idiopathic based on probable etiology, and analysed. Results: 85 patients were included. Mean age of patients was 61.6±17.54 years. Cardiovascular group had the highest number of patients (49.4%) of which atrial fibrillation was the most common etiology (59.5%). Malignancy was the most common etiology in the hypercoagulable disorder group (69.3%). Patients in the idiopathic group were significantly younger and had higher mean BMI than the other 2 groups at presentation. Smokers had 9 times higher risk of renal infarction in cardiovascular group and 1.7 times higher risk in hypercoagulable when compared to the idiopathic group. 48.2% of patients developed renal infarction though they were on antiplatelets/anticoagulants. Conclusion: ARI is a rare and often underdiagnosed condition that can have residual renal dysfunction. It is important to consider ARI as a differential especially in young patients with risk factors even if they are on anticoagulation medication.