Cholesterol Crystal Embolism and Chronic Kidney Disease
نویسندگان
چکیده
Renal disease caused by cholesterol crystal embolism (CCE) occurs when cholesterol crystals become lodged in small renal arteries after small pieces of atheromatous plaques break off from the aorta or renal arteries and shower the downstream vascular bed. CCE is a multisystemic disease but kidneys are particularly vulnerable to atheroembolic disease, which can cause an acute, subacute, or chronic decline in renal function. This life-threatening disease may be underdiagnosed and overlooked as a cause of chronic kidney disease (CKD) among patients with advanced atherosclerosis. CCE can result from vascular surgery, angiography, or administration of anticoagulants. Atheroembolic renal disease has various clinical features that resemble those found in other kidney disorders and systemic diseases. It is commonly misdiagnosed in clinic, but confirmed by characteristic renal biopsy findings. Therapeutic options are limited, and prognosis is considered to be poor. Expanding knowledge of atheroembolic renal disease due to CCE opens perspectives for recognition, diagnosis, and treatment of this cause of progressive renal insufficiency.
منابع مشابه
Molecular mechanisms of crystal-related kidney inflammation and injury. Implications for cholesterol embolism, crystalline nephropathies and kidney stone disease.
Crystals are particles of endogenous inorganic or organic composition that can trigger kidney injury when deposited or formed inside the kidney. While decades of research have focused on the molecular mechanisms of solute supersaturation and crystal formation, the pathomechanisms of crystal-induced renal inflammation remain largely unknown. The recent discovery of the intracellular NLRP3 inflam...
متن کاملCholesterol crystal embolism (atheroembolism)
Cholesterol crystal embolism, known as atheroembolic disease, is caused by showers of cholesterol crystals from an atherosclerotic plaque that occludes small arteries. Embolization can occur spontaneously or as an iatrogenic complication from an invasive vascular procedure (angiography or vascular surgery) and after anticoagulant therapy. The atheroembolism can give rise to different degrees of...
متن کاملIloprost in embolic renal failure.
Cholesterol embolism is a serious disease with a high morbidity and mortality rate. There is no clear evidence that any specific treatment helps this syndrome. We report a patient who developed acute renal failure due to cholesterol crystal embolism following percutaneous transluminal angioplasty of a renal artery. Treatment with iloprost for peripheral symptoms of cholesterol emboli resulted i...
متن کاملCholesterol crystal embolization.
of toes), strongly suggests this disease. Biopsy of the skin or the kidney demonstrates cholesterol crystals, biconvex, needle-shaped clefts whitin the occluded vessel. These intraluminal lesions are often accompanied by a perivascular inflammatory reaction that may contain eosinophils [2] . The reported incidence of renal atheroembolic disease during the last 10 years seems to have increased b...
متن کاملRetinal Emboli in Cholesterol Crystal Embolism
Cholesterol crystal embolism (CCE) is a rare and severe multisystemic disorder. It results from a massive release of cholesterol crystals from widespread atherosclerotic disease. The main difference with atherosclerosis is the severity and the quantity of the embolic events that occur during the course of the disease, eventually leading to multivisceral failure and death. The symptoms are multi...
متن کامل