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"Spontaneous" Atheroembolic Renal Failure

KENNETH KAPLAN, M.D.; J. DONALD MILLAR, M.D.; PASQUALE A. CANCILLA, M.D.
Arch Intern Med. 1962;110(2):218-221. doi:10.1001/archinte.1962.03620200078014.
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In recent years several observers have drawn attention to the significance of atheromatous renal embolization. Handler,1 in 1956, suggested that this may play an etiologic role in high blood pressure in the elderly. Thurlbeck and Castleman2 pointed out that the association of high blood pressure and renal atheromatous emboli did not necessarily determine which was etiologic. Their laboratory was the first to document acute renal failure due to atheromatous embolization. Of 22 patients dying after aortic surgery, 4 died with a clinical picture of anuria or oliguria and on postmortem examination showed "severe" renal atheromatous embolization. Four others had equally severe embolization, but died of other causes. More recently, Greendyke and Akamatsu3 reported 3 cases of renal failure in the absence of aortic surgery, in which there was a pathologic picture of extensive renal embolization and no "features of other renal diseases which might account for the

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