Acute Renal Infarction as a Cause of Low-Back Pain

Fernando de la Iglesia, MD, PHD; Pablo Asensio, MD, Alejandro Díaz, MD; Mercedes Darriba, MD; Ricardo Nicolás, MD, PHD; Fernando Diz-Lois, MD

Disclosures

South Med J. 2003;96(5)

Abstract and Introduction

Detection of acute renal infarction is often delayed or missed because of both the rarity of the disease and its nonspecific clinical presentation. Abrupt onset of low-back pain in a patient at high risk for a thromboembolic event may be the first indication of renal infarction. We report a case of acute renal infarction and review its diagnosis and management.

Introduction

Low-back pain is a prevalent problem and can account for up to 15% of all new outpatient visits.^[1] Low-back pain is usually a benign condition related to posture or physical strain, and it generally resolves spontaneously or is easily treated. Therefore, low-back pain often is not regarded as a symptom of serious disease. We encountered a case of acute renal infarction in a patient who had sudden onset of low-back pain. Patients with acute renal infarction usually present with persistent low-back, abdominal, and flank pain that suggests other, more common diseases such as lumbago, abdominal disease, urolithiasis, or even myocardial infarction.^[2] In addition, neither risk factors nor laboratory examinations that have a clinically acceptable specificity for acute renal infarction exist. Early diagnosis is mandatory to establish effective acute and long-term therapy for the preservation of renal function.

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