Overview

    Atheroembolic renal disease (AERD) occurs when cholesterol particles make their way into the kidney’s small blood vessels. This material clogs the vessels and causes the kidneys to begin to fail because they are deprived of blood. AERD is a serious condition. Treatment usually cannot restore kidney function, and the disease may eventually lead to death.

    Causes of AERD

    AERD is associated with atherosclerosis. This is a condition in which fat, cholesterol, and other substances harden along the walls of your major arteries. They form structures called plaques. With AERD, cholesterol crystals in plaque break away, travel through the bloodstream, and become lodged in kidney blood vessels. The blockage reduces blood flow and can cause swelling and tissue damage. Atherosclerosis of the aorta, the major artery in your body, is the most common cause of AERD.

    Certain medical procedures and surgery involving the aorta or other arteries can disturb plaques and cause crystals to dislodge. These disturbances are the main reason that AERD occurs, but crystals can break away spontaneously. Procedures that may lead to AERD if you have atherosclerosis include:

    • aorta angiography
    • cardiac catheterization
    • surgery on the aorta or other major arteries

    AERD Risk Factors

    Having atherosclerosis is the most important risk factor because it is a prerequisite for AERD. The following conditions can lead to atherosclerosis:

    • diabetes
    • high cholesterol levels
    • high blood pressure
    • infection
    • smoking

    Males appear to have a higher risk of developing AERD than females. Age is also a risk factor. AERD generally occurs in people over age 50.

    Recognizing the Symptoms of AERD

    AERD usually leads to acute or slowly progressing kidney failure. As the disease progresses various symptoms may appear, beginning with nausea, fatigue, loss of appetite, itching, and difficulty concentrating.

    In some cases, AERD causes no symptoms. If symptoms appear, they can begin suddenly or get worse over a period of weeks or months.

    Typical symptoms of AERD can include:

    • fever
    • muscle aches
    • headaches
    • weight loss
    • pain between your ribs and hip (flank)
    • foot pain
    • sores on the feet
    • blue toes
    • uncontrollable high blood pressure
    • loss of vision or blindness
    • abdominal pain
    • nausea
    • vomiting
    • blood in the urine (rare)

    The following additional symptoms may indicate kidney failure:

    • decreased sensation
    • decreased urine output
    • drowsiness
    • confusion
    • lethargy
    • dry, itchy skin
    • loss of appetite
    • changes in skin color
    • swelling of the legs

    Diagnosing AERD

    A kidney biopsy is usually the best method to diagnose AERD. A sample of your kidney tissue will be examined under the microscope for evidence of fatty material in the small arteries. Your doctor may also order blood and imaging tests to determine the severity of your case.

    AERD Treatment and Long-Term Outlook

    Currently there is no effective treatment for AERD. Most people live for a year, and about half live for four years after diagnosis, according to The Merck Manual Home Health Handbook. (Merck) The focus of most treatment is on managing the complications of organ damage.

    Dietary changes are usually necessary. Reducing fats and cholesterol in the diet can assist your kidneys in functioning better. Limiting protein, salts, and fluids may also be recommended. Dialysis might be needed during kidney failure. Several times a week, a machine will do the work of your kidneys. This involves removing waste and toxins from your blood and adjusting fluid levels. Your doctor may also prescribe medication to treat co-occurring conditions such as high cholesterol levels and high blood pressure.

    Preventing AERD

    You can address certain factors that increase the risk for developing AERD.

    Weight Loss

    Reducing weight can prevent diabetes and reduce strain on your body’s organs.

    Stop Smoking

    Smoking is known to cause multiple health problems. Smoking can reduce oxygen to the blood and adversely affect your kidneys.

    Maintain Good Health

    Following your doctor’s recommendations for controlling diabetes or high blood pressure can assist in preventing AERD.

    Eat Healthy

    A proper diet can boost the immune system. Reducing saturated fats can assist in reducing fat levels in the blood, which may help prevent AERD.