Abstract
ObjectivesFlank pain is a common symptom in the emergency department and can be caused by a variety of diseases. Renal infarction (RI) is a very rare disease, and many RI patients complain of flank pain. However, there is no definitive predictor of RI when patients complain of flank pain. This study aimed to identify the clinical factors for predicting RI in patients with flank pain.MethodsThis retrospective single-center study was conducted on patients complaining of flank pain from January 2016 to March 2020 at a South Korean tertiary care hospital. Exclusion criteria included patients who did not undergo contrast-enhanced computed tomography, age < 18 years, and trauma. Demographic and laboratory data were obtained from medical records. Logistic regression analysis was conducted to identify predictors of RI occurrence.ResultsIn all, 2,131 patients were enrolled, and 39 (1.8%) had RI. From a multivariable logistic regression analysis, an age ≥ 65 years (odds ratio [OR], 3.249; 95% confidence interval [CI], 1.366–7.725; p = 0.008), male sex (OR, 2.846; 95% CI, 1.190–6.808; p = 0.019), atrial fibrillation (OR, 10.386; 95% CI, 3.724–28.961; p < 0.001), current smoker (OR, 10.022; 95% CI, 4.565–22.001; p < 0.001), and no hematuria (OR, 0.267; 95% CI, 0.114–0.628; p = 0.002) were significantly associated with the occurrence of RI.ConclusionsFive clinical factors, i.e., age ≥ 65 years, male sex, atrial fibrillation, current smoker, and no hematuria, were significantly associated with the occurrence of RI in patients with flank pain.
Highlights
Flank pain is a common symptom in the emergency department (ED) that can be caused by various urinary and extra-urinary diseases [1]
From a multivariable logistic regression analysis, an age 65 years, male sex (OR, 2.846; 95% confidence intervals (CIs), 1.190–6.808; p = 0.019), atrial fibrillation (OR, 10.386; 95% CI, 3.724–28.961; p < 0.001), current smoker (OR, 10.022; 95% CI, 4.565–22.001; p < 0.001), and no hematuria (OR, 0.267; 95% CI, 0.114–0.628; p = 0.002) were significantly associated with the occurrence of Renal infarction (RI)
Renal infarction (RI), a disease that can occur in patients complaining of flank pain, develops when the renal artery flow is abruptly blocked, and previous studies have reported that the incidence rate of RI is 0.004–0.007% in the ED and that 65–85% of RI patients complain of flank pain [2, 3]
Summary
Flank pain is a common symptom in the emergency department (ED) that can be caused by various urinary and extra-urinary diseases (e.g., urolithiasis, tumor, lower lobe pneumonia, urinary tract infection, and cholecystitis) [1]. RI occurs very rarely and is not easy to diagnose early because its symptoms are similar to those of other diseases mentioned above, such as urolithiasis [1, 4, 5]. Acute RI is often diagnosed accidentally when treating patients complaining of flank pain or with other diseases [1, 2, 4]. An early diagnosis of acute RI is essential for effective treatment and to preserve renal function without leaving any other sequelae [2]
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