Cardiovascular · UKMLA & AKT

Renal artery thrombosis/embolism

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise renal artery thrombosis/embolism — the full SA Note notes add investigations, management, complications and 10 practice questions.

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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