Treatment of renal infarction

CT: computed tomography; AKI: acute kidney injury; CKD: chronic kidney disease; eGFR: estimated glomerular filtration rate; PET: percutaneous endovascular therapy; ECG: electrocardiogram.
* We initially check an ECG. Additional evaluation using Holter monitoring and transthoracic echocardiography may also be needed. Additional information on the diagnostic evaluation of atrial fibrillation can be found in the UpToDate topic on overview of atrial fibrillation.
¶ Refer to the UpToDate topic on evaluating adult patients with venous thromboembolism for acquired and inherited risk factors.
Δ Partial occlusion is suggested by uptake of contrast into the parenchyma perfused by the involved vessel and in the ipsilateral collecting system. Complete occlusion is suggested by complete lack of contrast uptake in the parenchyma perfused by the blood vessel.
◊ PET may include thrombolysis, thrombectomy, angioplasty, or stent placement. The choice of the endovascular procedure is left with the interventionalist or surgeon. If PET is not available, then such patients should undergo systemic thrombolysis.
§ Refer to the UpToDate topic on renal infarction for a discussion regarding dosing, titration, and duration of anticoagulation.