Thrombosis of the renal artery of a small, solitary kidney: successful return of renal function after prolonged anuria.

In the presence of a single functioning kidney, renal artery obstruction produces anuria, which can require hemodialysis. If the problem is diagnosed immediately and surgical intervention is not delayed, revascularization of the ischemic kidney is usually successful. Few authors, however, have reported the return of function to a small solitary kidney after occlusion lasting longer than 2 hours. We describe a case that involved thrombosis of the renal artery to an 8-cm solitary kidney; a successful endarterectomy was performed 29 hours after the onset of anuria. This case shows that the reversibility of renal ischemia is not necessarily determined by either the duration of occlusion or the size of the affected kidney.