Spontaneous renal artery dissection is rare and may be misdiagnosed because its clinical presentation is confusing. Diagnosis is usually made by angiography. The causes of renal artery dissection include blunt trauma, angioplasty, and atherosclerosis of the renal artery. Spontaneous arterial dissection can be associated with fibromuscular dysplasia, medial degeneration, polyarteritis nodosa, Marfan syndrome or syphilitic arteritis.
The most common presenting signs of renal artery dissection are flank pain, hypertension, headache, and abdominal bruit. Minimal proteinuria and microscopic hematuria may be detected, and dissection can lead to segmental or total renal infarction.
Conservative management is often indicated, and the long-term prognosis is generally excellent. Patients may also be treated surgically or with endovascular revascularisation. Surgical treatment of spontaneous renal artery dissection is indicated in patients who have hypertension despite medical treatment. Management methods for spontaneous renal artery dissection are surgical revascularisation, endovascular treatment, and medical treatment with or without anticoagulation. In the literature, a clear method of treatment with any of these modalities was not demonstrated. Some kidneys were lost due to irreversible ischaemic damage from an occlusive dissection. Isolated renal artery dissection is an uncommon lesion that can cause renal parenchymal loss and hypertension.