Renal vein thrombosis

Bohler J, Hauenstein KH, Hasler K, Schollmeyer P. Renal vein thrombosis in a dehydrated patient on an oral contraceptive agent. Nephrol Dial Transplant 1989 4(ll) 993-5. 

Twenty-five percent ofthrombophilic patients develop thrombosis at unusual sites resulting in cerebral venous thrombosis, mesenteric vein thrombosis, hepatic venous thrombosis, retinal vein thrombosis, purpura fulminans, splenic vein thrombosis, portal vein thrombosis, renal vein thrombosis, or axillary vein thrombosis. The thrombotic disorders may involve inflammatory factors that contribute to the vascular deficit. In addition, embolic events also play a role in the development of these thrombotic complications. 

Hepatic venous thrombosis, also known as Budd-Chiari syndrome, is caused by hypercoagulable disorders precipitated by pregnancy, infection, and birth control medication. An acute painful abdomen, sudden enlargement of the liver, and the presence of ascites make up a triad of clinical symptoms that are important in the diagnosis of this syndrome. Myeloproliferative disorders such as polycythemia vera and paroxysmal nocturnal dyspnea were previously thought to be responsible. Factor V Leiden and prothrombin 20210 mutations are also known to be responsible, Other intraabdominal thromboses include portal vein thrombosis, mesenteric vein thrombosis and renal vein thrombosis. 

Zoghby Z, Sekhon IS, Miller DV, Sethi S. Cocaine, loin pain, and renal vein thrombosis. Am J Kidney Dis. 2007 49(6) 859-861. 

The signs and symptoms are usually insidious in onset and may consist of anorexia, malaise, edema, anasarca, or ascites, and pericardial and pleural effusions may also be present. As a result of a hypercoagulable state, pulmonary embolism may develop, but rarely results in death. " The incidence of renal vein thrombosis varies from 5% to 62%, " and membranous nephropathy should be suspected when there is a sudden onset of hematuria loin pain pulmonary embolus fluctuating or worsening proteinuria or glomerular filtration rate renal tubular acidosis or an increase in leg edema. Hypertension is found in about 30% of patients and is more common in the presence of renal insufficiency or until the disease is advanced. 

A different kind of complication is proximal reflux of the sclerosing agent, vdiich can result in renal vein thrombosis. 

The incidence of bilateral renal vein thrombosis is increased in acute hyperparathyroidism, possibly as a result of generalized dehydration and hypercalcemia. In fact, renal vein thrombosis observed in acute para-thyroidism exemplifies the increased tendency to blood coagulation and thrombosis in hypercalcemic patients. An increased tendency to thrombosis is observed in other cases of hypercalcemia associated with plasmacytoma or metastatic myelomas and metastasizing tumors. 

A 58-year-old man had a gastric varix injected twice with a mixture of enbucrilate plus hpiodol and subsequently needed anticoagulant therapy for four episodes of venous thromboembolism. A CT scan showed a linear hyper-dense lesion in the left renal vein due to the presence of enbucrilate and renal vein thrombosis. The thrombus extended into the inferior vena cava and there was splenic infarction [37 ]. 

Renal artery thrombosis, renal vein thrombosis... 

Submersion of parenchymal pattern Renal vein thrombosis (1, 3,5, 7,10) Xanthogranulomatous pyelonephritis Neoplasm... 

Wright NB, Blanch G, WaUdnshaw S et al (1996) Antenatal and neonatal renal vein thrombosis new ultrasonographic features with high frequency transducers. Pediatr Radiol 26 686-689... 

Cases of asymmetric NC are described in children with hypercalcemia as being due either to unilateral renal vein thrombosis or unilateral hydronephrosis (Navarro et al. 1998). 

Fig. 20.16. A 2 -month-old boy after renal vein thrombosis. Sonogram of right kidney showing cortical nephrocalcinosis...

Neonatal aortic thrombosis Renal artery or renal vein thrombosis Renal artery stenosis Aortic disease... 

Hentschel R, Lodige B, Bulla M (1996) Renal insufficiency in the neonatal period. Clin Nephrol 46 54-58 Hibbert J, Hewlett DC, Greenwood et al (1997) The ultrasound appearances of neonatal renal vein thrombosis. Br J Radiol 70 1191-1194... 

Nuss R, Hays T, Manco-Johnson M (1994) Efficacy and safety of heparin anticoagulation for neonatal renal vein thrombosis. Am J Pediatr Hematol Oncol 16 127-131... 

Pohl M, Zimmerhackl LB, Heinen F et al (1998) Bilateral renal vein thrombosis and venous sinus thrombosis in a neonate with factor V mutation (FV Leiden). J Pediatr 132 159-161... 

Fig. 3. 22a,b. Renal vein thrombosis, a On the diastolic color flow image, all the arteries show a blue color compatible with a reversed flow, b The spectral waveform shows a holodiastolic reflux evocative of renal vein thrombosis... 

Fig. 3.23a-c. Partial renal vein thrombosis, a B-mode and b on color flow sonography show an echogenic thrombus ( ) within the lumen of the renal vein, c This early thrombus was confirmed by venography (arrow)... 

Fig. 3.24a-c. Renal vein thrombosis, a Color flow sonography shows thrombosed segmental veins within the renal sinus (arrow) and b transcapsular venous drainage, towards the external iliac vein, at the lower pole of the kidney, c The venous phase of renal DSA shows the absence of venous drainage through the normal renal vein and a heterogeneous renal parenchyma... 

Martinoli C, Crespi G, Bertolotto M et al (1996) Interlobular vasculature in renal transplants a power Doppler US study with MR correlation. Radiology 200 111-117 Matalon TA, Thompson MJ, Patel SK et al (1990) Percutaneous treatment of urine leaks in renal transplantation patients. Radiology 174 1049-1051 Melamed ML, Kim HS, Jaar BG et al (2005) Combined percutaneous mechanical and chemical thrombectomy for renal vein thrombosis in kidney transplant recipients. Am J Transplant 5 621-626... 

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