Renal vein thrombosis
| Renal vein thrombosis | |
 | |
|---|---|
| Transplant with Renal Vein Thrombosis: Gross; natural color, opened kidney and vein. Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology | |
| ICD-10 | I82.3 |
| ICD-9 | 453.3 |
| DiseasesDB | 11359 |
| MedlinePlus | 000513 |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saeedeh Kowsarnia M.D.[2]
Overview
Renal vein thrombosis (RVT) is the formation of a clot or thrombus obstructing the renal vein.
Classification
Acute Chronic
Unilateral bilateral
Pathophysiology
A hypercoagulable state or mechanical compression of the renal vein is often present in those patients with renal vein thrombosis. This can be due to malignancy or it can be due to the nephrotic syndrome. In nephrotic syndrome there is an excessive urinary protein loss which is in turn associated with decreased antithrombin III. It is unclear why the renal vein is susceptible to thrombosis in patients with nephrotic syndrome.
Causes
Common Causes
- Nephrotic syndrome
- Malignancy
- Trauma
- Oral contraceptive pills
- Hypovolemia
- Inherited coagulopathy
Uncommon Causes
- Antiphospholipid antibody syndrome
- Behçet's syndrome
- Hypercoagulable states
- Kidney transplant
- Renal cell carcinoma [1] [2]
Epidemiology and Demographics
Prevalence of renal vein thrombosis in nephrotic syndrome is 5 to 60% [3] .Membranous nephropathy is responsible for 20 to 60 % of the cases which makes it the most common cause of renal vain thrombosis. Other etiologies like minimal change disease, membranoproliferative glomerulonephritis, and focal segmental glomerulosclerosis cause 10 to 50 % of the cases.
Diagnosis
Symptoms
Back or flank pain may be present. Hematuria may be present.
Imaging
CT Scan
CT angiography can be used in diagnosis.[4]
Treatment
Surgery to remove the clot is possible, but rarely performed.
Anticoagulation therapy can have some benefits.[5]
Related Chapters
References
- ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
- ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X
- ↑ Rajni Singhal & K. Scott Brimble (2006). "Thromboembolic complications in the nephrotic syndrome: pathophysiology and clinical management". Thrombosis research. 118 (3): 397–407. doi:10.1016/j.thromres.2005.03.030. PMID 15990160.
- ↑ Asghar M, Ahmed K, Shah SS, Siddique MK, Dasgupta P, Khan MS (2007). "Renal vein thrombosis". European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 34 (2): 217–23. doi:10.1016/j.ejvs.2007.02.017. PMID 17543556.
- ↑ Zigman A, Yazbeck S, Emil S, Nguyen L (2000). "Renal vein thrombosis: a 10-year review". J. Pediatr. Surg. 35 (11): 1540–2. doi:10.1053/jpsu.2000.18302. PMID 11083418.