急性肾梗塞诊断和治疗.pptVIP

This lecture was conducted during the Nephrology Unit Grand Ground by Medical Student rotated under Nephrology Division under the supervision and administration of Prof. Jamal Al Wakeel, Head of Nephrology Unit, Department of Medicine and Dr. Abdulkareem Al Suwaida, Chairman of Department of Medicine. Nephrology Division is not responsible for the content of the presentation for it is intended for learning and /or education purpose only. RENAL INFARCTION Presented by: Dr. Barakat M. AL-Otaibi Medical Student August 2008 objectives Causes Diagnosis Treatment WHAT ARE THE CAUSES? EMBOLIZATION Thromboembolism: - atrial fibrillation,most common etiology (left atrium or left atrial appendage ) - left ventricular thrombus (myocardial infarction, dilated cardiomyopathy) - thromboemboli originating from complex plaque in the aorta. Valvular vegetations in infective endocarditis. Tumor and fat emboli and paradoxical embolism through a patent foramen ovale. EMBOLIZATION The reported incidence of renal thromboembolism in patients with atrial fibrillation was 2 % in a series of almost 30,000 patients followed for up to 13 years . Incident thromboembolism in the aorta and the renal, mesenteric, pelvic, and extremity arteries after discharge from the hospital with a diagnosis of atrial fibrillation. Arch Intern Med 2001; 161:272. WHAT ARE THE CAUSES? WHAT ARE THE CAUSES? Transesophageal echo showing a thrombus in the left atrial appendage of a patient with atrial fibrillation WHAT ARE THE CAUSES? Transesophageal echo showing spontaneous contrast smoke in the left atrial appendage of a patient with atrial fibrillation. WHAT ARE THE CAUSES? Left ventricular apical thombus THROMBOSIS Renal artery thrombosis: ( atherosclerotic renovascular disease, traumatic intimal tear, vasculitis). Spontaneous or iatrogenic renal artery or aortic dissection. Complication following endovascular (aortic or renal) interven