WHAT IS IT?

           To function properly, Kidneys need nutrients and oxygen, like any other organ. They obtain them through their blood supply.  When such blood supply to the Kidneys is insufficient, kidneys are unable to function well.  This condition is called Ischemic-Nephropathy.

            CAUSES:

            Some of the causes of Ischemic Nephropathy are:

                1.   Partial Blockage of the large Blood Vessels supplying
                        the blood to the Kidneys (Renal Arteries) usually due
                        to Cholesterol deposition in the walls of the blood vessels
                        or scarring of the blood vessels
                2.   Multiple blockages of smaller blood vessels within the
                        kidneys due to causes mentioned in 1.
                3.   Hardening of the millions of smallest blood vessels within
                        the kidneys (Atherosclerosis /  Nephrosclerosis)               

            SYMPTOMS:
                Ischemic Nephropathy (IN) could develop over a period of several years (chronic) or could occur suddenly (acute).  The symptoms of IN will depend on whether it is of chronic type or of acute onset.

             CHRONIC ISCHEMIC NEPHROPATHY:

                    1.   No symptoms at all or one or more of the following symptoms
                    2.   Symptoms related to proteinuria
                    3.   Symptoms related Chronic Renal Failure

             ACUTE ISCHEMIC NEPHROPATHY:

                    1.   Patients are usually severely ill.  The severity of the illness
                            is to a great part due to the condition that cause the Acute IN.
                            The conditions that predispose Acute IN are:
                                a.   Following surgeries on blood vessels esp Aorta like repair of
                                    Aortic aneurysms. (Cholesterol Emboli)
                                b.   Blood clots into the Kidneys
                                c.   Trauma to the Renal Arteries

                    2.   In addition to the symptoms related to the above predisposing conditions
                            Acute IN could cause:
                                a.   No symptoms at all and only abnormal blood tests, or one or more
                                    of the following symptoms
                                b.   Severe loin pain on one or both sides
                                c.   Hematuria (blood in the urine) that may or may not be
                                    visible to the naked eye
                                d.   Fever and chills
                                e.   Any or all of the symptoms of Acute Renal Failure

            TREATMENT:

                    A.   ACUTE ISCHEMIC NEPHROPATHY:

                          The treatment usually depends on the cause of the acute IN.  Sudden blockage
                            of the blood vessels to the kidneys need to be removed if possible.  This might
                            involve
                                        i.    angiograms (X-ray of the blood vessels)
                                        ii.   Dissolving the clot with medications (Thrombolysis) which
                                              is usually done at X-ray department
                                        iii. Removal of the clot Surgically
                            (Most of the time, the severe illness of the patient does not permit
                            any of the above measures)

                    B.   CHRONIC ISCHEMIC NEPHROPATHY:

                            1.   angiograms (X-ray of the blood vessels)
                            2.   Angioplasty (Done in X-ray department where the blocked
                                blood vessel is dilated with a balloon)
                            3. Under certain circumstances after dilating the blood vessel
                                as above, a stent could be inserted.  (Stent = a plastic or metal tube
                                inserted within the blood vessel so that the blood vessel will
                                remain open and will not close again)
                            4. Surgical repair of the blood vessel
                            5. If several very small blood vessels within the kidneys are
                                involved, then no satisfactory treatment is available.
                            6. Other concomitant treatments include
                                    i.    treatment of proteinuria
                                    ii.   treatment of Chronic Renal Failure
                                    iii. treatment of Hypertension
                                    iv. treatment of high Cholesterol (Hyperlipidemia)