Cardiovascular · UKMLA & AKT
Renal artery thrombosis/embolism
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Flank/loin pain - sudden, severe, constant (not colicky - unlike renal colic)
- Haematuria - macro- or microscopic
- AKI - rising creatinine; may be mild/absent in unilateral occlusion with healthy contralateral kidney
- Hypertension - acute renin release from ischaemic kidney activates RAAS
- Nausea/vomiting, fever - may mimic pyelonephritis
- Features of underlying cause - irregularly irregular pulse (AF), signs of infective endocarditis, widespread atherosclerosis
Classic triad: sudden flank pain + haematuria + AKI - but present in only a minority. Key clue: NO pyuria (distinguishes from pyelonephritis) + known embolic risk factor (e.g. AF). Markedly elevated LDH is a useful biochemical pointer to renal infarction.
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