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A disease of the kidneys caused by narrowing of the kidney blood vessels and/or blood clots that form in the renal artery as a complication of atherosclerosis (see also renal artery stenosis).

Causes and Risks

Atheroembolic renal disease is damage and destruction of kidney tissue due to atherosclerosis of the blood vessels that supply blood to the kidneys. Atherosclerosis occurs when cholesterol and other fats (lipids) deposit along the walls of the blood vessels. This causes the walls of the blood vessel to become less elastic, called "hardening of the arteries." The lipid deposits cause blood to flow unevenly, and this can result in the formation of blood clots that may cause partial or complete blockage of the blood vessel, or acute renal artery occlusion.

The clots can also travel to other parts of the body and damage other organs. This is knowns as embolization. Atherosclerosis of the aorta can lead to showers of small emboli containing cholesterol and debris. These emboli, if they travel to arteries that supply the kidneys, cause damage to, and death of, many small areas of the kidney. A permanent complication of this is acute renal failure or chronic renal failure.

The incidence of atheroembolic renal disease is 4 out of 10,000 people. It is more common in men, especially those over 60 years old. Risk factors for atherosclerotic disorders include having a personal or family history of cerebrovascular disease, heart disease, coronary artery disease, peripheral vascular disease, diabetes mellitus, and hypertension. Smoking, obesity, and high serum lipids (such as total cholesterol and triglycerides) also greatly increase the risk of atherosclerotic disorders.

Clots or emboli may form in the kidney due to atherosclerotic deposits, called plaques, or they may travel to the kidney from other locations. If you have previously had an episode of thromboembolism, or blood clots, elsewhere, the risk of having emboli that travel to the kidney increases. This is especially true if the previous episode was severe enough to require treatment with anticoagulants. Anticoagulant therapy may itself trigger an embolism. The risk of emboli is also increased with recent aortic surgery or procedures involving the blood vessels such as aortography or arteriography.

Atheroembolic renal disease may cause reduced kidney function including acute or chronic renal failure. It may also result in hypertension that is difficult to control. Sometimes the person will have no symptoms, unless acute arterial occlusion or renal failure develops. Hypertension, or high blood pressue, that is difficult to control may be the first clue that atheroembolic renal disease exists, or routine examination or examination for other disorders may reveal the disease.