The kidneys need a good blood supply. The main artery to the kidney is called the renal artery. Reduced blood flow through the renal artery can hurt kidney function. A complete blockage of blood flow to the kidney can often result in permanent kidney failure.
Acute arterial occlusion of the renal artery can occur after injury or trauma to the abdomen, side, or back. Blood clots that travel through the bloodstream (emboli) can lodge in the renal artery. Pieces of plaque from the walls of the arteries can come loose (on their own or during a procedure). This debris can block the main kidney artery one or one of the smaller vessels.
The risk of renal artery blockages increases in people who have certain heart disorders which make them likely to form blood clots. These include mitral stenosis and atrial fibrillation.
A narrowing of the renal artery is called renal artery stenosis. This condition increases the risk of a sudden blockage.
You may not have symptoms when one kidney does not function because the second kidney can filter the blood. However, high blood pressure (hypertension) may come on suddenly and be difficult to control.
If your other kidney is not working fully, blockage of the renal artery may cause symptoms of acute kidney failure. Other symptoms of acute arterial occlusion of the renal artery include:
Often, patients do not need treatment. Blood clots may get better on their own over time.
You may have treatment to open the artery if the blockage is discovered quickly or it is affecting the only working kidney. Treatment to open the artery may include:
Clot-dissolving medicines (thrombolytics)
Medicines that prevent the blood from clotting (anticoagulants), such as warfarin (Coumadin)
Surgical repair of the renal artery
Insertion of a tube (catheter) into the renal artery to open the blockage
You may need temporary dialysis to treat acute kidney failure. Medicines to lower cholesterol may be needed if the blockage is due to clots from plaque buildup in the arteries.
Damage caused by arterial occlusion may go away. However, in most cases it is permanent.
If only one kidney is affected, the healthy kidney may take over filtering the blood and producing urine. If you have only one working kidney, arterial occlusion leads to acute kidney failure. This can develop into chronic kidney failure.
Scolari F, Ravani P. Atheroembolic renal disease. Lancet. 2010;8:375(9726):1650-60.
Ruggenenti P, Cravede P, Remuzzi G. Microvascular and macrovascular diseases of the kidney. In: Taal MW, Chertow GM, Marsden PA, et al, eds. Brenner and Rector's The Kidney. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 34.
Melissa B Bleicher, MD, Division of Renal, Electrolyte, and Hypertension, Hospital of the University of Pennsylvania, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.