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Atheroembolic kidney disease — RCPSC IM MCQ

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HardNephrologyAtheroembolic kidney diseaseRCPSC IM

A 74-year-old man develops worsening kidney function 10 days after coronary angiography. Creatinine rises from 110 to 260 umol/L, eosinophils are 1.1 x 10^9/L, complements are low, urinalysis is bland, and examination shows livedo reticularis with blue toes despite palpable pulses. What is the most likely diagnosis?

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Correct answer: C — Cholesterol crystal embolisation

Subacute kidney injury after vascular manipulation with eosinophilia, low complement, livedo and blue toe syndrome suggests cholesterol crystal embolisation. Contrast-associated AKI usually occurs earlier and lacks systemic embolic features.

Reference: Canadian nephrology practice; KDIGO AKI guidance