CHOLESTEROL EMBOLI - A COMMON-CAUSE OF RENAL-FAILURE

Cholesterol embolization (CE), usually occurring in males in their six th or seventh decade of life, can affect multiple organ systems, inclu ding the kidney. Interventive diagnostic procedures and aortic surgery greatly increase the risk of CE. Rapid or insidious progression of re nal failure in association with surgical or diagnostic radiologic proc edures should suggest this diagnosis. Progressive rend insufficiency i n older patients with generalized arterial disease should suggest isch emic nephropathy secondary to bilateral renal artery stenosis, renal C E, or both. Recent worsening of hypertension is characteristic of eith er diagnosis. A number of clinical conditions can simulate renal CE, a nd final differentiation may be possible only by renal biopsy. Aggress ive, supportive management of renal CE is warranted because renal func tion may stabilize and, in a limited number of cases, may even improve .