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2017 ; 18
(6
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Cholesterol Crystal Embolism and Chronic Kidney Disease
#MMPMID28538699
Li X
; Bayliss G
; Zhuang S
Int J Mol Sci
2017[May]; 18
(6
): ä PMID28538699
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Renal disease caused by cholesterol crystal embolism (CCE) occurs when
cholesterol crystals become lodged in small renal arteries after small pieces of
atheromatous plaques break off from the aorta or renal arteries and shower the
downstream vascular bed. CCE is a multisystemic disease but kidneys are
particularly vulnerable to atheroembolic disease, which can cause an acute,
subacute, or chronic decline in renal function. This life-threatening disease may
be underdiagnosed and overlooked as a cause of chronic kidney disease (CKD) among
patients with advanced atherosclerosis. CCE can result from vascular surgery,
angiography, or administration of anticoagulants. Atheroembolic renal disease has
various clinical features that resemble those found in other kidney disorders and
systemic diseases. It is commonly misdiagnosed in clinic, but confirmed by
characteristic renal biopsy findings. Therapeutic options are limited, and
prognosis is considered to be poor. Expanding knowledge of atheroembolic renal
disease due to CCE opens perspectives for recognition, diagnosis, and treatment
of this cause of progressive renal insufficiency.
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