Atheromatous Emboli with Progressive Renal Failure

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Abstract
Two patients studied by renal arteriography for hypertension evaluation subsequently developed progressive deterioration of renal function and within 2-4 months died in uremia. Atheroembolic disease of the kidney, severe enough to account for the renal failure, was demonstrated by renal biopsy or autopsy. Both patients had severe erosive atheromatous disease of the abdominal aorta and underlying nephrosclerosis with moderate renal insufficiency. The temporal relationship between arteriography and the deterioration of renal function, the actual demonstration of embolization during the arteriographic procedure in 1 and the findings of extensive athero-embolism of the kidneys in both indicated renal arteriography as a critical initiating factor. Unless indications are urgent, renal arteriography should probably be avoided in patients with extensive arteriosclerosis and impaired renal function. When used, manipulation with rigid catheters should be held to a minimum.