Key result
Systemic anticoagulation successfully manages extensive unilateral renal infarction as the initial presentation of AF.
Why the study?
Acute renal infarction in the context of atrial fibrillation is rare and commonly underdiagnosed due to its vague presentation in the emergency department.
Case Report (n=1)
No
Acute renal infarction should be considered in the differential diagnosis for older patients with cardiovascular risk factors presenting with abdominal pain, as early systemic anticoagulation can preserve renal function.
Renal infarction may signal undiagnosed AF; this case leaves open whether systematic screening or anticoagulation protocols are warranted.
Objective: Acute renal infarction in the context of atrial fibrillation (AF) is rare, and its vague presentation means it is commonly underdiagnosed in the emergency department. Its consideration in the differential diagnosis of patients presenting with abdominal pain and a history of cardiovascular disease is, however, important as timely management with systemic anticoagulation or catheter-directed thrombolysis can preserve renal function. Case Presentation: We present a case of an 82-year-old male who was found to have an entire renal infarction as his initial presentation of AF. He was successfully treated with systemic intravenous anticoagulation. Other causes of ARI were ruled out, and he was commenced on prophylactic antibiotics. He was switched to long-term oral anticoagulation before discharge. Conclusion: Early systemic anticoagulation remains the most commonly employed treatment strategy for long-term nephron preservation. Further studies are needed to identify the optimal emergency treatment strategy for this rare but significant disease entity.
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Fonseka et al. (2026) conducted a case report in Acute renal infarction and Atrial fibrillation (n=1). Systemic anticoagulation was evaluated. An 82-year-old male presenting with extensive unilateral renal infarction as the initial manifestation of atrial fibrillation was successfully treated with systemic anticoagulation.
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