SynopsisCodesDifferential Diagnosis & PitfallsBest TestsReferences
Renal artery atheroembolism
Other Resources UpToDate PubMed

Renal artery atheroembolism

Contributors: Catherine Moore MD
Other Resources UpToDate PubMed


Caused by dislodged fragments of atherosclerotic plaque embolizing to the renal arteries, this is an infrequent cause of subacute kidney injury. The most common etiology is an iatrogenic event, such as cardiac angiography, cardiac surgery, or anticoagulation in the setting of atherosclerosis.

Clinical symptoms are the same as those that present with acute or chronic renal failure with uremia. Abdominal pain, nausea, and vomiting may occur due to arterial microcirculation of abdominal organs. Blindness and yellow retinal plaque formation (Hollenhorst plaques) can occur due to retinal arteriolar emboli. Clinical signs of peripheral embolism may be present, such as gangrene, livedo reticularis, and painful muscle nodules.

Treatment involves addressing the source of emboli (when possible), controlling hypertension, and managing fluids and electrolytes. Some patients may require renal replacement therapy initially.

Patients with renal artery atheroembolism usually have a poor long-term prognosis.


I74.9 – Embolism and thrombosis of unspecified artery

95580006 – Renal artery embolism

Differential Diagnosis & Pitfalls

  • Acute interstitial nephritis
  • Contrast-induced nephropathy – Typically the time course of acute kidney injury in this case would be within 72 hours of the contrast exposure, whereas renal artery atheroembolism typically has a delayed onset of injury.
  • Volume-responsive Acute kidney injury
  • Acute tubular necrosis
  • Cardiorenal syndrome

Best Tests

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Last Updated:05/12/2019
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Renal artery atheroembolism
A medical illustration showing key findings of Renal artery atheroembolism : Hematuria, Leg pain, Proteinuria, ESR elevated, BP increased
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