Background:The atheroembolic renal disease (AERD) is part of multisystem disease is characterised by as renal failure and evidence of peripheral cholesterol embolization. There is no data regarding AERD from India except for few case reports. The present study is the first of its kind from India to report on AERD. 

Materials and methods: All the patients who were referred to Nephrology unit at Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala and diagnosis as AERD based on clinical presentation and/or biopsy, were included in the study.

Results: There were 11 cases of renal failure (males:10; female:1), aged 55-75 years (Mean: 60; SD:9.5 years) due to AERD, with varying precipitating factors. Majority (9 out of 11) of the patients had precipitating factors for atheroembolization. Majority (10 out of 11) of the patients had severe acute renal failure (ARF) (eGFR <30 ml/min/1.73m2) requiring dialysis therapy. All those requiring renal replacement therapy (RRT) were treated with hemodialysis. Of the 10 patients who required hemodialysis only 4 patients could discontinue hemodialysis after 2 weeks to 6 months and rest were continuing hemodialysis at the time of study. The patient, who did not need dialysis, had partial improvement in renal function with conservative treatment.  

Conclusions:The AERD is one the causes for renal failure in elderly patients undergoing vascular intervention procedures and thrombolysis, especially if they have underlying atherosclerotic vascular disease. Majority of the affected patients are males of elderly age and have precipitating factors for atheroembolization in form of coronary interventions, thrombolysis or intake of antiplatelet agents. Majority of the presented with acute renal failure. Majority of patients with AERD require renal replacement therapy (RRT) and have poor chance of renal recovery.

Keywords: Atheroembolic renal disease, rapidly progressive renal failure, thrombolysis, coronary angiography, anticoagulation.