Atheroemboli - renal

Definition

Atheroembolic renal disease (AERD) is an inflammatory reaction in the small blood vessels of the kidneys.

Alternative Names

Renal disease - atheroembolic; Cholesterol embolization syndrome; Atheroemboli - renal; Atherosclerotic disease - renal

Causes

AERD is linked to atherosclerosis. Atherosclerosis is a common disorder of the arteries. It occurs when fat, cholesterol, and other substances build up in the walls of arteries and form hard substances called plaque.

In AERD, cholesterol crystals from plaque break off and move to the kidneys and into the blood stream. Once in circulation, the crystals get stuck in tiny blood vessels called arterioles. There, they cause an intense inflammatory response. The result is organ damage due to decreased blood supply. Acute kidney failure is possible if the reaction is severe.

Atherosclerosis of the aorta is the most common cause of AERD. The cholesterol crystals may also break off during cardiac catheterization or aortic surgery.

In some cases, AERD may occur without a cause.

The risk factors for AERD are the same as risk factors for atherosclerosis.

Symptoms

AERD may not cause any symptoms. Symptoms that may occur include:

Kidney failure may result in the following:

Exams and Tests

The doctor will perform a physical exam. Swelling may affect the entire body. An eye exam may show particles in the small arteries of the retina.

The doctor will listen to your lungs and heart with a stethoscope. Abnormal sounds may be heard. For example, a loud whooshing sound called a bruit may be heard over the aorta or renal artery.

Blood pressure may be high. There may be multiple ulcers of the skin of the lower feet.

Tests that may be done include:

Treatment

Medicines may be used to treat high blood pressure and lower lipid and cholesterol levels.

Other treatments for kidney failure or complications may be needed.

Your doctor may tell you to reduce fats and cholesterol in your diet. If you have kidney failure, you may need to restrict protein, salt, and fluids, or make other dietary changes.

Your doctor may also recommend other lifestyle changes such as increased exercise or weight loss. Stopping smoking is extremely important.

Outlook (Prognosis)

The outcome varies but is generally poor. The disorder slowly gets worse over time. Lifestyle changes may help slow progression of the disease.

Possible Complications

When to Contact a Medical Professional

Call your doctor if you have:

Prevention

You can alter the factors that increase your risk of getting this disease. You should lose weight if you are obese, decrease or stop smoking, and follow your doctor's recommendations to control diabetes or high blood pressure. Reducing fats, especially saturated fats, in your diet may help to reduce serum lipid levels.