Atheroembolie denotes the closure of renal arterioles by atherosclerotic emboli, leading to a progressive kidney damage. The emboli originating from ruptured atheromatous plaques. The symptoms are similar to those of kidney failure. There may be symptoms and findings of an extensive arterioembolischen disease. The diagnosis is made by renal biopsy. The long-term prognosis is poor in general. The treatment aims to prevent further embolism.

Atheromatous plaque rupture resulting usually from a manipulation of the aorta and other large arteries during vascular surgery, angioplasty or arteriography. A spontaneous plaque rupture, which occurs most often in patients who have a diffuse erosive atherosclerosis or who are treated with anticoagulants or fibrinolytic agents is rare.

Atheroembolie denotes the closure of renal arterioles by atherosclerotic emboli, leading to a progressive kidney damage. The emboli originating from ruptured atheromatous plaques. The symptoms are similar to those of kidney failure. There may be symptoms and findings of an extensive arterioembolischen disease. The diagnosis is made by renal biopsy. The long-term prognosis is poor in general. The treatment aims to prevent further embolism. Atheromatous plaque rupture resulting usually from a manipulation of the aorta and other large arteries during vascular surgery, angioplasty or arteriography. A spontaneous plaque rupture, which occurs most often in patients who have a diffuse erosive atherosclerosis or who are treated with anticoagulants or fibrinolytic agents is rare. Atheroembolien rather cause an incomplete closure with secondary ischemic atrophy as a renal infarction. Often the embolization followed by a foreign body immune response, which results within 3-8 weeks in further deterioration of renal function. Through massive or recurrent episodes of embolization acute renal failure can result. Symptoms and signs The symptoms generally correspond to those of an acute or chronic renal insufficiency with uremia (Acute kidney injury (AKI): symptoms and complaints). Renal Atheroembolie rarely causes hypertension. Abdominal pain, nausea and vomiting may disturbed by an attending arterial microcirculation of the abdominal organs (eg. B. pancreas, gastrointestinal tract) originate. Sudden blindness and the formation of yellow spots on the retina (Hollenhorst plaques) may result from embolism of the retinal arterioles. Characters of an extended peripheral embolism (z. B. livedo reticularis, painful muscle knots, open gangrene, which are often referred to as the “trash syndrome”) occur occasionally. Diagnosis Clinical suspicion Imaging techniques Sometimes renal biopsy (usually renal ultrasonography) localization of the origin of embolism The suspected diagnosis is made due to a deterioration of renal function in patients with recent manipulation of the aorta, especially if there are signs of Atheroembolien. For differential diagnosis includes a contrast-and drug-induced nephropathy. An imaging procedure should be performed (usually sonography). If the suspected Atheroembolie remains high, a percutaneous renal biopsy is performed. This has a sensitivity of about 75%. The diagnosis is important because treatable causes an embolism may be present without a vascular obstruction is present. Cholesterol crystals in the emboli dissolve during tissue fixation and leave pathognomonic biconcave, needle-like cracks in the sealed vessel. Sometimes the same change that indirectly helps in diagnosis seen in skin-muscular or gastrointestinal biopsies. Blood and urine tests help the diagnosis of acute kidney injury or chronic Nierenerkrankungzu place, but say nothing about its cause. Urinalysis typically shows microscopic hematuria and low proteinuria. Sometimes, however, the proteinuria is also in the nephrotic range (> 3 g / day). It can happen eosinophilia, and transient Eosinophilurie hypocomplementemia. Renal Atheroembolie figure provided by Agnes Fogo, M.D., and the American Journal of Kidney Disease, Atlas of Renal Pathology (see www.ajkd.org). var model = {thumbnailUrl: ‘/-/media/manual/professional/images/renal_atheroembolism_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/-/media/manual/professional/images/renal_atheroembolism_high_de.jpg?la = en & thn = 0 ‘, title:’ Renal Atheroembolie ‘description:’ u003Ca id = “v37896976 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eRenale Atheroembolien dissolve during tissue fixation and left biconcave acicular cracks of 100-200 microns in diameter in the vessels (silver staining according to Jones

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