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Abstract: PO0790

Renal Artery Thrombosis with Infarction in a Patient with Mild COVID-19

Session Information

Category: Trainee Case Report

  • 000 Coronavirus (COVID-19)


  • Mocerino, Ryan, Montefiore Medical Center, Bronx, New York, United States
  • Kumar, Neelja D., Montefiore Medical Center, Bronx, New York, United States

There has been increased focus on the microvascular and macrovascular complications of COVID-19. Here we present a case of renal arterial thrombosis in a woman with mild symptoms of COVID-19.

Case Description

A 69 year old female with diabetes, hypertension, coronary artery disease, and acute embolic cerebrovascular event post cardiac catheterization in 2016 presented to the emergency department with acute diffuse intermittent abdominal pain and nonbloody emesis. Prior to this, she had been evaluated for cough, shortness of breath and myalgias which were conservatively managed with improvement. Her medications included aspirin, clopidogrel, furosemide, and insulin. Examination was significant for diffuse nonspecific abdominal tenderness without rebound or guarding. Laboratory assessment revealed preserved renal function with creatinine of 1.10 mg/dL and PCR positive for SARS-CoV-2. A computed tomography of the abdomen and pelvis with intravenous contrast revealed a non-occlusive thrombus in the left renal artery with several large wedge-shaped areas of decreased enhancement consistent with multiple left renal infarctions. On interdisciplinary discussion, the patient was managed conservatively with anticoagulation without acute intervention and was discharged home on apixaban.


To our knowledge, this is the first description of renal artery thrombosis with renal infarction in the setting of COVID-19 infection. Patients who present with a COVID-19 infection, regardless of disease severity, should be evaluated for coagulopathy and development of thrombi as these may potentially contribute to infarction and end-organ damage. Although it requires a high index of suspicion, renal infarction should be considered part of the differential when evaluating a patient with COVID-19 infection presenting with abdominal pain or acute kidney injury. Initiation of anticoagulation should be considered with consideration of risks involved.