Renal Infarction: Clinical and Evolutionary Aspects in the Nephrology Department Ibn Sina University Hospital of Rabat-Morocco

Abstract

Introduction: Renal infraction is a rare medical-surgical emergency that should be evoked before any lumbar pain syndrome. We report in this work, two cases of renal infraction with their clinical evolution.

Clinical Observation: These patients, aged respectively 48 and 70 years, were hospitalized in our department concomitant for low back pain. Emboligenic heart disease was responsible for the renal infraction in both cases. Diagnostic certainty was established by a CT scan with injection of contrast medium. Renal function was normal in the young patient versus renal insufficiency at 20mg/l creatinine for a GFR estimated at 35ml/minute according to MDRD in the elderly patient. We had a clinical and biological improvement with a curative anticoagulant treatment relayed by a long term treatment with an anti vitamin K in both cases but the elderly man kept a sequential renal insufficiency.

Conclusion: Acute renal infarction is a rare pathology which must be systematically evoked in front of a lumbar pain syndrome. Angioscan with injection of contrast medium allows to make the diagnosis. Heparinization at an effective dose is the mainstay of treatment in the case of unilateral involvement, or surgery if bilateral.