Research Article

Acute Kidney Injury due to spontaneous Atheroembolic disease, superimposed on diabetic nephropathy, with no recent vascular or cardiac intervention, presented as Rapidly Progressive Glomerulonephritis (RPGN)

Anas Diab*, Parravani Anthony, Hollie Berryman and Kareem Diab

Published: 07/14/2021 | Volume 5 - Issue 2 | Pages: 053-055

Atheroembolic disease (AED), or Cholesterol Crystals Embolism, is a systemic disease presented as a complication of severe atherosclerosis [1], where older age, male sex, diabetes hypercholesterolemia, smoking and hypertension [2], are the main risk factors for the development of  Atherosclerosis, it is known that spontaneous atherosclerotic renal disease is rare in the absence of any vascular intervention [3], and in the absence of anticoagulant [4], or the absence of calcified aorta, with the most common presentation of the disease is subacute kidney injury progress into renal dysfunction occurs in like a staircase pattern and the renal dysfunction is usually observed several weeks after a possible intervention, caused by dislodging the  micro cholesterol plaques from a major artery, and start showering multiple organs causing micro and macro embolic phenomena.

Read Full Article HTML DOI: 10.29328/journal.jcn.1001074 Cite this Article

References

  1. Kronzon I, Saric M. Cholesterol embolization syndrome. Circulation 2010; 122: 631-641. PubMed: https://pubmed.ncbi.nlm.nih.gov/20697039/
  2. Tanaka H, Yamana H, Matsui H, Fushimi K, Yasunaga H, et al. Proportion and risk factors of cholesterol crystal embolization after cardiovascular procedures: a retrospective national database study. Heart Vessels 2020; 35:1250-1255. PubMed: https://pubmed.ncbi.nlm.nih.gov/32277287/
  3. Nickol J, Richards T, Mullins J. Cholesterol Embolization Syndrome From Penetrating Aortic Ulcer. Cureus 2020; 12: e8670. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7370687/  
  4. Muller-Hansma AHG, Daemen-Gubbels CRGM, Schut NH. Cholesterol embolisms as possible adverse drug reaction of direct oral anticoagulants. Neth J Med 2018; 76:125-128. PubMed: https://pubmed.ncbi.nlm.nih.gov/29667588/
  5. Scolari F, Ravani P. Atheroembolic renal disease. Lancet 2010; 375: 1650-1660. PubMed: https://pubmed.ncbi.nlm.nih.gov/20381857/
  6. Cosio FG, Zager RA, Sharma HM. Atheroembolic renal disease causes hypocomplementaemia. Lancet 1985; 2: 118-121. PubMed: https://pubmed.ncbi.nlm.nih.gov/2862317/
  7. Ridker PM, Cannon CP, Morrow D, Rifai N, Rose LM, et al. C-reactive protein levels and outcomes after statin therapy. N Engl J Med. 2005; 352: 20-28. PubMed: https://pubmed.ncbi.nlm.nih.gov/15635109/
  8. Vaidya PN, Finnigan NA. Atheroembolic Kidney Disease. 2021. PubMed: https://pubmed.ncbi.nlm.nih.gov/29494024/
  9. Matsumura T, Matsumoto A, Ohno M, Suzuki S, Ohta M, et al. A case of cholesterol embolism confirmed by skin biopsy and successfully treated with statins and steroids. Am J Med Sci 2006; 331: 280-283. PubMed: https://pubmed.ncbi.nlm.nih.gov/16702800/