Renal artery dissection causing renal infarction in otherwise healthy men

Amir Alamir, Donald F. Middendorf, Peter Baker, Norris Stanley Nahman, Arthur B. Fontaine, Lee A. Hebert

Research output: Contribution to journalArticle

57 Scopus citations

Abstract

Arterial dissection is usually associated with pathological states such as malignant hypertension, severe atherosclerosis, severe trauma, Marfan syndrome, or Ehlers-Danlos syndrome. However, we report three cases in which renal artery dissection occurred in otherwise healthy, normotensive men. In two cases, the onset of symptoms of renal artery dissection was coincident with an unusual degree of physical activity. In the third case, the symptoms occurred while the patient was sitting but during a stressful business meeting. In each case, the patient experienced severe unilateral flank pain. Urolithiasis was suspected, but intravenous pyelography showed only ipsilateral impaired renal cortical perfusion, and the urinalyses showed no hematuria. The diagnosis of renal artery dissection was established by arteriography in two cases and by nephrectomy in one case. The latter case showed fibromuscular dysplasia by arteriography performed after the nephrectomy. The other two cases showed no evidence of fibromuscular dysplasia. We conclude that spontaneous renal artery dissection can occur in otherwise healthy individuals. Our experience and the reports of others indicate that this condition occurs mainly in men, conservative (nonsurgical) management is generally indicated, and the long-term prognosis is generally excellent. In some patients, an unusual degree of physical exertion might be the cause of renal artery dissection.

Original languageEnglish (US)
Pages (from-to)851-855
Number of pages5
JournalAmerican Journal of Kidney Diseases
Volume30
Issue number6
DOIs
StatePublished - Jan 1 1997
Externally publishedYes

Keywords

  • Arterial dissection
  • Renal artery disease
  • Renal infarction

ASJC Scopus subject areas

  • Nephrology

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    Alamir, A., Middendorf, D. F., Baker, P., Nahman, N. S., Fontaine, A. B., & Hebert, L. A. (1997). Renal artery dissection causing renal infarction in otherwise healthy men. American Journal of Kidney Diseases, 30(6), 851-855. https://doi.org/10.1016/S0272-6386(97)90094-9