Acute renal infarction: long-term renal outcome and prognostic factors.

Introduction: Acute renal infarction is a rare occurence, whose  prognosis and long-term outcomes remain poorly studied. This study evaluated whether clinical and radiological features at diagnosis can be associated with the long-term outcomes (blood pressure, kidney function and mortality).
Methods: We retrospectively analyzed the demographic, clinical, biological and radiological data of patients with acute renal infarction hospitalized at Rennes University Hospital between 1997 and 2017 (n = 94).
Results: Patients were followed-up for a median of 60 months. At time of diagnosis of acute renal infarction median age was 53 years, 45% of the patients had acute hypertension, and 31% had Acute Kidney Injury (AKI) requiring dialysis in seven patients. The median Lactate DeHydrogenase (LDH) level was 977 IU/mL. The median extent of kidney damage was 14%, with left renal involvement in 51% of patients. At 60 months of follow-up, 66% of patients had developed Chronic Kidney Disease (CKD) stage 3 or higher, and 55% had hypertension since diagnosis. Age, acute development of hypertension and AKI at diagnosis were associated with long-term CKD (stage 3 or higher) in multivariate analyses, but the extent of kidney damage was not. During the follow-up, 21% of patients died, and only age resulted as a predisposing factor. No tested factor was correlated with long-term hypertension.
Discussion: Age, acute development of hypertension, and AKI were correlated with long term CKD, whereas no factor was correlated with long-term hypertension after acute renal infarction.
(© 2021. Italian Society of Nephrology.)