There are two renal veins left and right that are responsible for draining oxygendepleted. Blood clotting where it shouldnt or when you dont want it to. Basterrechea iriarte f, sota busselo i, nogues perez a. Citations may include links to fulltext content from pubmed central and publisher web sites. It is also important to differentiate bland thrombus from tumor thrombus. Inferior vena caval ivc thrombosis is an essential diagnosis while evaluating any neoplastic lesion, or portal hypertension. The north american pediatric renal transplant cooperative study naprtcs reported that graft thrombosis represented the main cause of graft failure in the first year. It is typically seen in patients suffering from nephrotic syndrome, but may also be diagnosed in individuals with renal malignancies, and hypercoagulable states. The major causes of renal vein thrombosis rvt are nephrotic syndrome and malignancy. Oct 23, 2017 renal vein thrombosis rvt is a blood clot that develops in one or both of the renal veins. Complications specific to the underlying cause, eg graft failure after renal transplantation. Earlier reports, from postmortem examinations, had correctly cited infectious suppuration, malignancy, and trauma as likely causes of rvt. Renal vein thrombosis occurs in up to 4% of transplant recipients. Venous thrombotic complications are well recognized but arterial complications are rare.
Renal vein thrombus is commoner on the left side, presumably due to the left renal vein being considerably longer than the right. Jun 30, 2016 in 1840, rayer first described the association between renal vein thrombosis rvt and nephrotic syndrome. Thrombosis may occur in veins venous thrombosis or in arteries arterial thrombosis. Especially in young and otherwise healthy patients, clinicians are easily misled by clinical presentation and calcified rvt. Rivers pollock, the obstetric physician to the westminster hospital, who sustained a traumatic thrombosis of the inferior vena cava and thereafter had gross albuminuria which persisted until his death 25 years later. Ortiz mendez vm, bonilla aguirre r, olvera hidalgo c, jurado mendoza j.
The term renal vein thrombosis rvt is used to describe presence of. Renal vein thrombosis can be either from bland thrombus or tumor thrombus extension of tumor into the vein. Renal vein thrombosis genitourinary disorders merck. Renal vein thrombosis european journal of vascular and. Renal vein thrombosis rvt is a blood clot that develops in one or both of the renal veins.
Renal vein thrombosis is thrombotic occlusion of one or both main renal veins, resulting in acute kidney injury or chronic kidney disease. Inferior venacavography and selective renal veno graphy is the. Venous thrombosis leads to congestion of the affected part of the body, while arterial thrombosis and rarely severe venous thrombosis affects the blood supply and leads to damage of the tissue supplied by that artery ischemia and necrosis. Oct 31, 2018 decoster t, schwagten v, hendriks j, beaucourt l.
Clinical symptoms are variable and may be often masked by underlying conditions. Recent surgical and perioperative advances have for the most part optimized the clinical outcome of such patients. Renal colic as the first symptom of acute renal vein thrombosis, resulting in the diagnosis of nephrotic syndrome. Thrombosis is multifactorial, and has been attributed to a hypercoaguable. Renal allograft thrombosis may be responsible for 27% of early allograft losses in adults 1 and up to 35% in children 2. Ascending thrombosis involving inferior vena cava and renal.
Treatment of caval vein thrombosis associated with renal tumors. Bilateral renal vein thrombosis and acute renal failure. Apr 20, 2011 inferior vena caval filters may be used in bilateral renal vein thrombosis. There are numerous etiologies for bland thrombus, but it most commonly occurs in the hypercoagulable nephrotic syndrome.
Presents with symptoms of renal infarction, including flank pain, hematuria microscopic or gross, low grade fevers elevation in ldh renal enlargement bilateral disease, solitary kidney, or transplant may present with acute renal failure increase in proteinuria from increased pressure. Renal vein thrombosis rvt is the formation of a clot or thrombus obstructing the renal vein. Treatment of renal vein thrombosis is very important since it carries a high mortality rate. Far less frequent is a combined thrombosis of renal veins and inferior vena cava in the pediatric age. Inferior venacavography and selective renal venography is the definitive diagnostic test. Renal vein thrombosis may occur bilaterally in 24% of newborns with almost half extending into the ivc. Renal vein thrombosis rvt with flank pain, and hematuria, is often mistaken with renal colic originating from ureteric or renal calculus.
Renal vein thrombosis an overview sciencedirect topics. Pubmed comprises more than 26 million citations for biomedical literature from medline, life science journals, and online books. Renal vein thrombosis rvt is the formation of a clot in the vein that drains blood from the kidneys, ultimately leading to a reduction in the drainage of one or both kidneys and the possible migration of the clot to other parts of the body. With acute renal vein thrombosis, both renal function and symptoms of renal vein thrombosis have been shown to improve once anticoagulation therapy is started. The risks of renal vein thrombosis include perinatal asphyxia, shock, polycythemia, cyanotic congenital heart disease, maternal diabetes, and sepsis, which result in reduced renal flow, hyperviscosity, hyperosmolality, and hypercoagulability. Get a printable copy pdf file of the complete article 1.
Renal vein thrombosis is a condition characterized by renal dysfunction secondary to a clot blocking the renal vein, which drains blood from the kidney. Based on the onset of symptoms renal vein thrombosis can be classified into acute and chronic. A 38yearold woman presented with flank pain and hematuria suggestive of renal calculus on ultrasound. Renal vein thrombosis rvt, the presence of thrombus in the major renal veins or its tributaries, is a rare clinical entity. In a patient with lupus, the appearance of sudden unexplained flank pain should raise suspicion for renal vessel thrombosis, of which renal vein thrombosis is more common than arterial. Both arterial and venous thrombosis may occur and systemic cerebral involvement very common as well as peripheral vessels are involved. Mechanisms of thrombosis maureane hoffman, md, phd professor of pathology. Surgery may be necessary for renal vein thrombosis caused by renal cell cancer. Evolution of imaging in renal vein thrombosis in the newborn. In acute situations, thrombolytic clotbusting medication may be infused into the renal artery for several hours to several days to break up the clot. Inferior vena cavagram revealing obliteration of ivc, with collateral flowthrough the azygos veins.
With acute renal vein thrombosis, both renal function and symptoms of renal vein thrombosis have been shown to improve once anticoagulation therapy is. Bilateral renal vein thrombosis and acute renal failure due to inferior vena cava filter thrombosis. Common causes include nephrotic syndrome, primary hypercoagulability disorders, malignant renal tumors, extrinsic compression, trauma, and rarely inflammatory. Thrombosis may extend from the vena cava into the peripheral venules or. Renal vein thrombosis as a presenting symptom of multiple genetic procoagulant defects. Inferior vena caval thrombosis radiology reference article. Treatment of a renal artery thrombosis depends on the type acute or chronic of thrombosis, and the length of time since the thrombosis occurred. Rayer was the first to describe thrombosis of renal vein in nephrotic patients during postpartum. Thrombosis is a frequent cause of morbidity and mortality in patients with the nephrotic syndrome.
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