Cholesterol Emboli
What is it?
Cholesterol emboli are small pieces of fatty material
that break off the wall of a blood vessel and travel to
the small renal arteries, where they block the blood
supply to the kidneys.
Who gets it?
Cholesterol emboli are more likely to occur in the
elderly, and are more common in males than females. They
affect Caucasians more often than blacks. Those at higher
risk include people with severe atherosclerotic disease, a
thickening of the artery walls; hypertension; diabetes;
and aortic aneurysm.
What causes it?
Fatty material, called cholesterol, builds up on the
walls of the blood vessels. It can sometimes break off
spontaneously and travel through the bloodstream. In some
cases, the emboli can be released into the bloodstream
during vascular surgery; thrombolysis, a procedure used to
dissolve or destroy clots in a blood vessel or in a
chamber of the heart; or diagnostic procedures such as
angiography, a test used to detect a blockage or defect in
an artery. It can also occur as a result of treatment with
anticoagulants, which prevent blood clotting.
What are the symptoms?
Patients with cholesterol emboli may not experience any
symptoms until the kidneys are close to complete failure.
When the kidneys fail, urine production decreases and
toxins and fluids build up in the bloodstream. The excess
fluid causes swelling, or edema, usually in the hands,
feet, face, and abdomen. The extra fluid also causes the
blood pressure to rise. Other symptoms may include nausea,
fatigue, confusion, joint pain, reduced urination, blood
in the urine, seizures, headaches, itching, and pain in
the kidney area. Blockage of a renal artery can cause
areas of the kidney tissue to die, called infarction.
How is it diagnosed?
It is sometimes difficult to diagnose cholesterol
emboli because the symptoms do not occur until weeks to
months after the occurrence of the causing factor. For
this reason, your doctor will study your medical history
to determine if you have had any recent procedures that
can cause cholesterol emboli, or fit any of the risk
factors. People with cholesterol emboli usually show a
combination of acute renal (kidney) failure and a
condition called eosinophilia, a high number of
eosinophils. Eosinophils are a type of white blood cell
that is released to destroy abnormal cells. Blood tests
will also show high levels of waste products, which are
not being filtered by the kidneys. A small sample of
kidney tissue may be removed through a procedure called a
biopsy. Small particles of fatty material blocking the
small arteries are often visible under a microscope.
What is the treatment?
Because cholesterol emboli are usually not discovered
until the patient is in advanced kidney failure, the only
treatment is dialysis, a procedure in which waste products
are filtered from the blood because the kidneys cannot, or
kidney transplant. In patients with high risk factors for
cholesterol emboli, it is best to avoid anticoagulation
treatments, vascular surgery, and angiography unless
absolutely necessary.
Self-care tips
Early diagnosis of cholesterol emboli is important in
preventing future episodes. If you have any of the known
risk factors for this condition, it is important to see
your doctor immediately if you have any warning signs of
kidney dysfunction, such as changes in the amount and
frequency of urination, difficulty urinating, or an
increase in nighttime urination.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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