A Clinical Evaluation for The Initial Diagnosis of Renal Infraction in Emergency fdedical Center

ABSTRACT

To evaluate appropriate diagnostic studies for renal infarction in emergency medical center, we analysed 33 patients of renal infarction treated in this hospital for last 8 years. Eleven patients, 4 trauma associated and 7 aortic disease associated patients were excluded. They are 11 males and 11 females with a mean age of 51 years. Fourteen came to the emergency medical center and seven came to the outpatient department, in the other one patient renal infarction was developed during hospitalization with other disease. On their past history they had hypertension in 9, valvular heart disease in 5, and diabetic mellitus in 4 patients. Abdominal or flank pain was noted in 17 of 22(77%). The other symptoms were vomiting, nausea, fever and so on. On microscopic examination of initial urine in hospital, 5 patients showed more than 10 red blood cells by high power field examination. The mean lactic dehydrogenase level was 1,239 I.U/L(normal range 218-4721.UA), while the mean aspartate aminotransferase and mean alanine aminotransferase were 511.U/L(normal range 13-36 I.U/L) and 44 I.U/L(normal range 5-331.U/L). Abdominal ultrasonography showed positive findings in 5 of 16(31%), of which 3 were confirmed by Doppler ultrasonography In 18, computed topography was done and all those showed positive findings of renal infarction(100%). In conclusion, it is important that identify the elevated lactic dehdrogenase level in case of any suspicion about renal infarction and confirm by computed tomography.