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'''For patient information page, click [[{{PAGENAME}} (patient information)|here]] | |||
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==Overview== | ==Overview== | ||
'''Renal vein thrombosis''' (RVT) is the formation of a [[clot]] or [[thrombus]] obstructing the [[renal vein]]. | '''Renal vein thrombosis''' (RVT) is the formation of a [[clot]] or [[thrombus]] obstructing the [[renal vein]]. | ||
==Pathophysiology== | ==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. | 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=== | ===Common Causes=== | ||
*[[Nephritic syndrome]] (defined as >3 g/d protein loss in the urine | * [[Nephritic syndrome]] (defined as >3 g/d protein loss in the urine | ||
* [[Hypoalbuminemia]] | |||
* [[Hypercholesterolemia]] | |||
* [[Edema]] | |||
===Uncommon Causes=== | ===Uncommon Causes=== | ||
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*[[Renal cell carcinoma]] <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref> | *[[Renal cell carcinoma]] <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref> | ||
==Symptoms== | ==Epidemiology and Demographics== | ||
Among patients with nephrotic syndrome, the incidence of real vein thrombosis is quite variable. Some reports place the incidence at 5% while others place it at 62%. | |||
==Diagnosis== | |||
===Symptoms=== | |||
Back or [[flank pain]] may be present. [[Hematuria]] may be present. | Back or [[flank pain]] may be present. [[Hematuria]] may be present. | ||
== | ===Imaging=== | ||
====CT Scan==== | |||
CT angiography can be used in diagnosis.<ref>{{cite journal |author=Asghar M, Ahmed K, Shah SS, Siddique MK, Dasgupta P, Khan MS |title=Renal vein thrombosis |journal=European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery |volume=34 |issue=2 |pages=217–23 |year=2007 |pmid=17543556 |doi=10.1016/j.ejvs.2007.02.017}}</ref> | CT angiography can be used in diagnosis.<ref>{{cite journal |author=Asghar M, Ahmed K, Shah SS, Siddique MK, Dasgupta P, Khan MS |title=Renal vein thrombosis |journal=European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery |volume=34 |issue=2 |pages=217–23 |year=2007 |pmid=17543556 |doi=10.1016/j.ejvs.2007.02.017}}</ref> | ||
| Line 49: | Line 54: | ||
Anticoagulation therapy can have some benefits.<ref name="pmid11083418">{{cite journal |author=Zigman A, Yazbeck S, Emil S, Nguyen L |title=Renal vein thrombosis: a 10-year review |journal=J. Pediatr. Surg. |volume=35 |issue=11 |pages=1540–2 |year=2000 |pmid=11083418 |doi=10.1053/jpsu.2000.18302}}</ref> | Anticoagulation therapy can have some benefits.<ref name="pmid11083418">{{cite journal |author=Zigman A, Yazbeck S, Emil S, Nguyen L |title=Renal vein thrombosis: a 10-year review |journal=J. Pediatr. Surg. |volume=35 |issue=11 |pages=1540–2 |year=2000 |pmid=11083418 |doi=10.1053/jpsu.2000.18302}}</ref> | ||
== | ==Related Chapters== | ||
* [[Nephrotic syndrome]] | * [[Nephrotic syndrome]] | ||
==References== | ==References== | ||
{{Reflist|2}} | |||
==External links== | ==External links== | ||
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{{Circulatory system pathology}} | {{Circulatory system pathology}} | ||
[[Category:Nephrology]] | [[Category:Nephrology]] | ||
[[category:Disease]] | |||
[[es:Trombosis de la vena renal]] | [[es:Trombosis de la vena renal]] | ||
Revision as of 19:48, 27 September 2012
| 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 |
For patient information page, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Renal vein thrombosis (RVT) is the formation of a clot or thrombus obstructing the renal vein.
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
- Nephritic syndrome (defined as >3 g/d protein loss in the urine
- Hypoalbuminemia
- Hypercholesterolemia
- Edema
Uncommon Causes
- Antiphospholipid antibody syndrome
- Behçet's syndrome
- Hypercoagulable states
- Kidney transplant
- Renal cell carcinoma [1] [2]
Epidemiology and Demographics
Among patients with nephrotic syndrome, the incidence of real vein thrombosis is quite variable. Some reports place the incidence at 5% while others place it at 62%.
Diagnosis
Symptoms
Back or flank pain may be present. Hematuria may be present.
Imaging
CT Scan
CT angiography can be used in diagnosis.[3]
Treatment
Surgery to remove the clot is possible, but rarely performed.
Anticoagulation therapy can have some benefits.[4]
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
- ↑ 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.
External links
- Overview at Merck Manual
- Diagnosis at wustl.edu