Acute renal failure caused by unilateral renal artery thromboembolism.

Thromboembolic obstruction of major renal arteries is a rare but serious clinical problem. A diagnosis is not usually established until irreversible renal parenchymal damage occurs. Emboli to the major renal arteries are associated with cardiac diseases and arrhythmia, among which atrial fibrillation is a major cause. The clinical manifestations of renal artery thromboembolism vary substantially, depending on whether the embolic occlusion affects both renal arteries or the artery of a solitary kidney, or occurs in a single kidney with a contralateral functioning kidney. We describe here a case of chronic atrial fibrillation and congestive heart failure complicated with right renal artery thromboembolism and acute renal failure, which initially presented as acute abdomen and was diagnosed incidentally by contrast-enhanced computerized tomography (CT) of the abdomen. The patient received intra-arterial thrombolytic treatment with urokinase, and regained his renal function after successful revascularization.