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      Acute Oliguric Renal Failure Associated with Unilateral Renal Embolism: A Successful Treatment with Iloprost

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          A 66-year-old woman presented with acute-onset rapid atrial fibrillation and right upper quadrant pain which had appeared 24 h prior to admission. The patient also manifested acute oliguric renal failure (serum creatinine 6.9 mg/dl). Selective renal angiography revealed total occlusion of the right renal artery with normal visualization of the left kidney vasculature. The patient was treated with intra-arterial urokinase and intravenous heparin, with no response. Intravenous administration of the prostacyclin analogue, iloprost, resulted in rapid resolution (within hours) of the oliguric acute renal failure, in spite of the continuing presence of a nonfunctioning right kidney. We conclude that the etiology of the acute renal insult in this patient is probably related to unilateral renal arterial embolization accompanied by arterial spasm of the unaffected kidney. The contralateral vasospasm can be reversed by iloprost, which then leads to a rapid recovery from acute renal failure. We are unaware of prior reports documenting the beneficial effect of iloprost in a clinical setting as described here.

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          Author and article information

          Am J Nephrol
          American Journal of Nephrology
          S. Karger AG
          October 1998
          10 September 1998
          : 18
          : 5
          : 444-447
          Departments of a Nephrology and b Nuclear Medicine, Rambam Medical Center, Technion School of Medicine Haifa, Israel
          13368 Am J Nephrol 1998;18:444–447
          © 1998 S. Karger AG, Basel

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          Page count
          Figures: 2, Tables: 1, References: 13, Pages: 4
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          Case Report

          Cardiovascular Medicine, Nephrology

          Acute renal failure, Iloprost, Renal artery embolism, Vasospasm


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