Abstract
An 80-year-old female was admitted to our hospital for left back pain, epigastralgia, vomiting, and diarrhea. As she exhibited severe renal dysfunction, anuria, and congestive heart failure, hemodialysis was started on day three. The patient had an elevated serum lactate dehydrogenase level (2,270 U/mL), and contrast-enhanced computed tomography revealed multiple defects in the left renal parenchyma associated with marked right renal atrophy. She was diagnosed with a renal infarction. Echocardiography showed large thrombi in the left and right atria (42×26 mm and 21×17 mm, respectively) together with a dilated left atrium and a normal left ventricular ejection fraction. Heparin was administered intravenously for seven days followed by the oral administration of warfarin for renal thrombosis and bilateral atrial thrombosis. However, the patient’s renal function did not improve, and the hemodialysis was continued. Here, we report a rare case of renal infarction associated with atrial fibrillation and unusually large atrial thrombi.
