Atheroembolic Renal Disease

 Atheroembolic renal disease is caused by occlusion of small arteries in the kidneys by cholesterol crystal emboli from ulcerated atherosclerotic plaques and is a part of systemic atheroembolism disease. Atheroembolic renal disease (AERD), also called atheroembolism , cholesterol embolism , cholesterol atheroembolic renal disease , or cholesterol crystal embolization , often is an underdiagnosed clinical illness. The kidney is usually involved because of proximity of the renal arteries to abdominal aorta, wherein the erosion of atheromatous plaque is most likely to occur. Cholesterol embolism also can occur in other visceral organs, as well as in the upper and lower extremities. Because the renal arteries have their origin from abdominal aorta and an enormous amount of blood flows through the kidney, it becomes a prime target in cholesterol crystal embolization.

AERD can be defined as renal failure secondary to the occlusion of renal arteries, arterioles, and glomerular capillaries with atheromatous plaques that are dislodged from the aorta and other major arteries. The release of cholesterol plaques into the circulation can occur spontaneously or after intravascular trauma with angiographic catheters or after the use of anticoagulants and thrombolytic agents. Like the native kidneys, a transplanted kidney also can be affected with cholesterol embolism and it should be considered in the differential diagnosis of worsening renal allograft function. Furthermore, AERD should be distinguished from other embolic disorders, such as atrial fibrillation, left atrial myxoma, and bacterial endocarditis.