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Atheroembolic Renal Disease (AERD), also known as cholesterol crystal embolism, is a kidney disorder caused by the blockage of small renal arteries with cholesterol crystals that dislodge from atherosclerotic plaques. These emboli can obstruct blood flow, triggering inflammation and ischemic injury in kidney tissues. The condition often occurs after vascular interventions such as angiography, stent placement, or anticoagulant therapy, which can disturb atherosclerotic plaques.

Patients typically present with a gradual decline in kidney function, high blood pressure, and systemic signs such as skin changes (livedo reticularis, blue toes), retinal emboli, or gastrointestinal symptoms. Laboratory findings may include eosinophilia, elevated serum creatinine, and low complement levels.

Diagnosis is often clinical but may be confirmed by kidney biopsy showing cholesterol clefts within small arteries. Treatment focuses on supportive care—managing blood pressure, maintaining kidney function, and avoiding further plaque disruption. Statins are commonly used to stabilize atherosclerotic lesions, and corticosteroids may help reduce inflammation in some cases.

The prognosis depends on the extent of vascular involvement and underlying comorbidities. Early recognition and preventive measures are essential to minimize kidney damage and improve long-term outcomes in patients at risk.