End stage renal disease. N18.6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2019 edition of ICD-10-CM N18.6 became effective on October 1, 2018.
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Introduction. Acute renal infarction (ARI) refers to ischaemic damage of the renal parenchyma caused by the sudden interruption of blood flow. It is a rare cause of acute kidney failure, with an incidence rate in published series ranging from 0.007% to 1.4%.
Neoplasm of unspecified behavior of right kidney D49. 511 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM D49. 511 became effective on October 1, 2021.
The two major causes of renal infarction are thromboemboli and in situ thrombosis. Thromboemboli usually originate from a thrombus in the heart or aorta, and in situ thrombosis is usually due to an underlying hypercoagulable condition or injury to or dissection of a renal artery.
Renal infarction results from interruption of the normal blood supply to part of, or to the whole kidney. The main imaging differential diagnosis includes pyelonephritis and renal tumors.
89 Other specified disorders of kidney and ureter.
0: Injury of kidney.
The most sensitive and specific imaging test for renal infarction is renal artery angiography. This test, however, is invasive and may be avoided in many cases. Other imaging modalities have been employed, with contrast CT used commonly in recent years.
Renal Infarction In such situations, CEUS can demonstrate absence of enhancement of the affected renal tissue (Fig. 34.4). Acute infarcts typically are seen as wedge-shaped, nonenhancing areas within an otherwise normal-appearing kidney. Renal shape is preserved.
The diagnosis of acute renal infarction is often delayed or missed. The condition is an important cause of renal loss and can point to serious cardiovascular disease.
Acute occlusion of the renal artery causes clear clinical symptoms (Halpern, 1967). Generally, a small renal infarction gives no symptoms. If symptoms exist, they are rather slight--flank pain, albuminuria, fever, and microscopic hematuria.
The optimal treatment for renal infarction due to thromboemboli, in situ thrombosis, or renal artery dissection is uncertain because there are no comparative studies. Reported approaches include anticoagulation, endovascular therapy (thrombolysis/thrombectomy with or without angioplasty), and open surgery.
Comment: Renal infarcts usually appear as well-demarcated, wedge-shaped or triangular areas of coagulative necrosis that extend from the capsular surface into the medulla. The characteristic shape results from the kidney's unique vascular supply.