Bilateral Renal Artery Thrombosis Research Articles

How Should Concurrent Arterial and Venous Thrombosis Associated With SARS-CoV-2 Infection Be Managed?

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), is associated with a high incidence of thrombotic complications involving both the arterial and the venous systems. However, concurrent arterial and venous thrombosis is extremely rare. Herein, we present the case of a 75-year-old male patient with severe COVID-19 who developed bilateral renal artery thrombosis and pulmonary embolism during the disease course. To our knowledge, this is the first such case described in the literature.LEARNING POINTSSARS-CoV-2-related coagulopathy is associated with both arterial and venous thrombotic events, which increase morbidity and mortality.Concurrent arterial and venous thrombotic events attributed to SARS-CoV-2 are extremely rare.A high index of clinical suspicion is required, while further research is needed to determine the optimal type, dose and duration of anticoagulation in such cases.

Triple threat: bilateral renal artery thrombosis and heparin induced thrombocytopenia in a patient with COVID-19, a case report

Triple threat: bilateral renal artery thrombosis and heparin induced thrombocytopenia in a patient with COVID-19, a case report

Isolated renal mucormycosis presenting with bilateral renal artery thrombosis: a case report

BackgroundMucormycosis is a rare infection caused by the fungus belonging to the order Mucorales. Mucormycosis predominantly affects immunocompromised individuals such as people with acquired immunodeficiency syndrome, blood malignancies, organ transplant, etc. Involvement of the kidneys usually occurs as a result of disseminated mucormycosis. We report a very rare case of isolated renal mucormycosis in an immunocompetant individual without any prior comorbidities who had an unusual presentation of mucormycosis.Case presentationA 17-year-old male student had presented to our emergency department with complaints of bilateral loin pain and fever for 10 days. There was no urine output for 2 days. Patient was in sepsis with acute kidney injury. A Doppler ultrasound of the abdomen revealed bilateral enlarged kidneys with absent blood flow in the renal vasculature. Dialysis was done, and patient was started on intravenous antibiotics. Patient was investigated for thrombophilia, the test results of which were normal. Sickle cell test was negative. Immunodeficiency screening was negative. Contrast-enhanced computed tomography revealed bilateral enlarged kidneys with bilateral renal artery thrombosis and mild ascitis. CT-guided renal biopsy was performed in the same sitting which revealed fungal hyphae in the background of necrotic glomeruli. Patient was started on liposomal amphotericin B with renal replacement therapy. However, patient deteriorated and succumbed to sepsis on the 4th day of admission.ConclusionIsolated renal mucormycosis with bilateral renal artery thrombosis is a very rare clinical scenario with high mortality. One must have a high degree of suspicion to diagnose renal mucormycosis at an early stage.

Anuria as a Chief Presentation of Takayasu Arteritis, a Case Report

Takayasu vasculitis is a rare type of large vessel vasculitis that primarily affects the aorta and its main branches; signs and symptoms are usually due to systemic inflammation or ischemia of an organ or limb, depending on the group of blood vessels involved. In addition, Takayasu arteritis is associated with increased platelet and coagulation activity, leading to a hypercoagulable state and thrombus formation. We report a case of a 47-year-old male who presented with a history of complete anuria for 3 days and was found to have progressively worsening kidney function. Renal Doppler ultrasound confirmed the presence of bilateral renal artery thrombosis, while Contrast- Enhanced Computed Tomography (CECT) of the abdomen and pelvis showed extensive abdominal aortic thrombosis with radiological findings consistent with large vessel vacuities. After catheter-directed thrombolytic therapy of the renal arteries, the patient started producing urine and his kidney function significantly improved. Later, Positron Emission Tomography scan (PET) confirmed large vessel Takayasu arteritis. Echocardiography showed no intracardiac thrombus, along with an extensive work up for thrombophilia, as autoimmune and vasculitis serology came back negative. This is an extremely rare presentation of Takayasu arteritis, with an unusual recovery of acute renal failure after delayed anuria due to bilateral renal artery thrombosis.

Anuria as a Chief Presentation of Takayasu Arteritis

Takayasu vasculitis is a rare type of large vessel vasculitis that primarily affects the aorta and its main branches; signs and symptoms are usually due to systemic inflammation or ischemia of an organ or a limb, depending on the group of blood vessels involved. In addition, Takayasu arteritis is associated with increased platelet and coagulation activity, leading to a hypercoagulable state and thrombus formation. We report a case of a 47-year-old male who presented with a history of complete anuria for 3 days and was found to have progressively worsening kidney function. Renal Doppler ultrasound confirmed the presence of bilateral renal artery thrombosis, while contrast-enhanced computed tomography (CECT) of the abdomen and pelvis showed extensive abdominal aortic thrombosis with radiological findings consistent with large vessel vacuities. After catheter-directed thrombolytic therapy of the renal arteries, the patient started producing urine and his kidney function significantly improved. Later, positron emission tomography scan (PET) confirmed large vessel Takayasu arteritis. Echocardiography showed no intracardiac thrombus, along with an extensive work-up for thrombophilia, as autoimmune and vasculitis serology came back negative. This is an extremely rare presentation of Takayasu arteritis, with an unusual recovery of acute renal failure after prolonged anuria due to bilateral renal artery thrombosis.

Bilateral Renal Artery Thrombosis in a COVID-19 Patient with Anuric AKI

Bilateral Renal Artery Thrombosis in a COVID-19 Patient with Anuric AKI

Catheter-Directed Thrombolysis in a Child with Bilateral Renal Artery Graft Thrombosis

A 5-year-old boy with midaortic syndrome who had undergone aortic bypass and bilateral renal artery grafts presented to the emergency department 1 year after surgery with symptoms of nausea, vomiting, and abdominal pain. Because of delay in diagnosis of bilateral renal artery thrombosis, his condition progressed to anuric renal failure. He underwent catheter-directed thrombolysis 7 days after presentation with administration of tissue plasminogen activator and heparin infusion over a 24-hour period. There was successful resolution of thrombus and complete recovery of renal function to baseline. The patient had normal renal function at 6-month follow-up.

Traumatic Bilateral Renal Artery Thrombosis: A Case of Kidney Salvage with Local Lytic Therapy and Systemic Anticoagulation in the Setting of Poly-trauma

We present a case of acute blunt traumatic bilateral renal artery thrombosis in the setting of multisystem trauma. Catheter-directed thrombolysis with tissue plasminogen activator afforded kidney salvage with return of glomerular filtration rate to normal values at the time of patient discharge. included a small left subdural hematoma, a left hemothorax and lung contusion. Bilateral renal infarctions with traumatic renal vascular thrombosis, and a right renal pelvis tear with minimal contrast extravasation was demonstrated. The remaining abdominal viscera were without acute injury. The right renal infarct was extensive compared to the left and involved the majority of the right kidney (Figure 1). A visceral angiogram confirmed bilateral renal infarctions, greater in the right kidney. The thrombus on the right renal artery was large and extending to several interlobar arteries (Figure 2). A catheter was placed in the right main renal artery for infusion of tissue plasminogen activator (TPA) at 2 mg/hr for four hours after an initial bolus of 8 mg for a total dose of 16 mg. The time from injury to the treatment with TPA was approximately 5 hours. The patient was also placed on systemic heparin drip due to the bilateral nature of the renal artery thrombosis. This decision was made following consultation with a neurosurgeon as the patient also had an acute subdural bleed. A collaborative decision was reached to proceed with

Successful revascularisation following delayed presentation of bilateral renal artery thrombosis after blunt abdominal trauma

Traumatic blunt abdominal bilateral renal artery thrombosis is a rare entity leading to end stage renal disease and has significant morbidity due to renal replacement therapy. Previously many attempts of revascularisation beyond 24 h have led to failure. We report a case of delayed presentation of bilateral renal artery thrombosis in which revascularisation was attempted beyond 24 h and was successful in terms of patient becoming dialysis-free.

Bilateral renal artery thrombosis in inherited thrombophilia: a rare cause of acute kidney injury

We describe the case of a 47-year-old man who developed significant acute, and subsequently chronic, kidney injury due to bilateral renal infarction. This occurred in the context of a combined inherited thrombophilia including antithrombin III deficiency and a prothrombin gene mutation. Bilateral renal artery thrombosis developed despite prophylactic treatment for thromboembolism. Arterial thrombosis is rare in the context of inherited thrombophilia and bilateral renal infarction is an unusual cause of acute kidney injury. Bilateral renal infarction due to primary renal artery thrombosis has not been previously described in antithrombin III deficiency, either as an isolated defect or in combination with other hereditary thrombophilia.

Bilateral renal artery thrombosis secondary to acute necrotizing pancreatitis.

Renal artery thrombosis is a rare, but serious and often under-diagnosed condition. We report a case of bilateral renal artery thrombosis secondary to acute necrotizing pancreatitis. A 66-year-old female presented with abdominal pain and acute kidney injury (AKI). A renal biopsy showed organized intraluminal thrombi and a computer tomography scan of the abdomen showed bilateral renal artery thrombosis. Emergent laprotomy showed necrosed pancreas. Doppler studies showed deep vein thrombosis of the lower extremities and internal jugular vein thrombosis. Workup for hypercoagulability was unremarkable. The final diagnosis was AKI secondary to bilateral renal artery thrombosis probably due to hypercoagulability of acute necrotizing pancreatitis.

Acute Peritoneal Dialysis in the Newborn Period: A 7-Year Single-Center Experience at Tertiary Neonatal Intensive Care Unit in Turkey

To evaluate the underlying causes and outcomes of neonates who underwent acute peritoneal dialysis (APD). This report describes a 7-year experience with APD in 77 neonates. Underlying causes requiring APD were acute tubular necrosis (ATN; n = 53), inborn error of metabolism (n = 18), bilateral renal vein thrombosis (n = 3), obstructive uropathy (n = 2; posterior urethral valve and neurogenic bladder), and bilateral renal artery thrombosis (n = 1). Fifteen of the 53 patients developed post-cardiac surgery ATN. The mean dialysis duration was 6.2 ± 10.7 days (range 1 to 90 days). Complications of procedure were hyperglycemia (n = 35), leaking of dialysate (n = 13), peritonitis (n = 10), catheter obstruction (n = 3), bleeding when inserting the catheter (n = 3), exit site infection (n = 2), and bowel perforation (n = 1). There were 57 deaths (74%) in this high-risk group due to underling causes. Of the 20 survivors, 16 patients showed a full renal recovery, but mild chronic renal failure developed in 1 patient and proteinuria with/without hypertension in 3 patients. Peritoneal dialysis is an effective means of renal replacement therapy in the neonatal period in the management of metabolic disturbances as well as renal failure. Although major complications of procedure are not so common, these patients have high mortality rates due to the serious nature of the primary causes.

Bilateral renal artery dissection following extreme exertion

Dissection of a renal artery is rare and is usually associated with underlying arterial disease. Bilateral renal artery dissection following extreme exertion is exceptionally uncommon, and thus presents a diagnostic challenge. We report a case of a middle-aged, otherwise healthy man who presented to the hospital with left flank pain after a long bicycling trip. Initial laboratory tests and urinalysis were normal. Careful review of a contrast-enhanced computed tomography angiogram (CTA) with 3D reconstruction revealed bilateral segmental renal artery dissection and thrombosis with corresponding renal infarcts. He was treated medically and rapidly recovered.

Traumatic Bilateral Renal Artery Thrombosis: Case Report and Review of the Literature

Traumatic Bilateral Renal Artery Thrombosis: Case Report and Review of the Literature

Traumatic bilateral renal artery thrombosis: case report and review of the literature

Traumatic bilateral renal artery thrombosis: case report and review of the literature

Successful delayed bilateral renal revascularization during active phase of Takayasu's arteritis

Successful bilateral renal revascularization was performed 24 days after the development of angiotensin converting enzyme-inhibitor–induced bilateral renal artery thrombosis and anuric acute renal failure in a patient with Takayasu's arteritis. Excellent results were obtained after an unusually long ischemic time for a patient with active-phase disease. The outcome suggests that aggressive surgical revascularization can benefit patients with renal failure caused by renal arterial occlusion during the active phase of Takayasu's arteritis. (J Vasc Surg 1998;27:552-4.)

Traumatic bilateral renal artery thrombosis: Pitfalls in computed tomographic diagnosis

Traumatic bilateral renal artery thrombosis (BRAT) is a rare injury that requires rapid recognition to optimize the chances for successful revascularization. The computed tomographic (CT) findings of BRAT may not be readily appreciated, since the injury potentially results in symmetrically diminished nephrograms. When CT is performed in the setting of acute trauma, particularly when using fast or spiral scanning techniques, bilateral renal contrast excretion into the collecting systems must be documented to ensure renal perfusion. When the CT diagnosis is equivocal, CT-angiography or conventional renal angiography is indicated.

Successful renal autotransplantation in a patient with bilateral renal artery thrombosis

Bilateral renal artery thrombosis is a rare but traumatic injury that is most commonly caused by sudden deceleration. Traditional methods of repair (e.g., in situ repair, bypass graft, and thrombectomy) have poor success rates. This report is the first successful use of autotransplantation in a patient with bilateral renal artery thrombosis.

Traumatic Bilateral Renal Artery Thrombosis Diagnosed by Computed Tomography with Successful Revascularization

Traumatic bilateral renal artery thrombosis is a rare injury. We found 15 cases previously reported. An additional case report of a 54-year-old man is presented with a review of the literature. The diagnosis was made by computed tomography and confirmed by angiography. Successful revascularization was performed. A high index of suspicion, early diagnosis, and prompt revascularization are essential in obtaining optimal results without hypertension or permanent impairment of renal function.

Isolated Bilateral Renal Artery Thrombosis

Bilateral renal artery thrombosis with anuria following blunt abdominal trauma is distinctly unusual. We report a 16-year-old female in whom emergency revascularization with a primary reimplantation on the right and a hypogastric artery interposition graft on the left was performed following angiographic documentation of bilateral renal artery occlusion. Excellent renal function was demonstrated bilaterally at 7 weeks. Bilateral renal revascularization is feasible in the acute setting and can yield excellent results.