Skip to main content
Log in

Left renal vein entrapment: a frequent feature in children with postural proteinuria

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

In most Asian subjects with postural proteinuria, ultrasonic imaging and Doppler flow scanning disclose entrapment of the left renal vein in the fork between the aorta and the superior mesenteric artery. Little information is available on the possible occurrence of left venal rein entrapment in European subjects with postural proteinuria. Renal ultrasound with Doppler flow imaging was therefore performed on 24 Italian or Swiss patients with postural proteinuria (14 girls and ten boys, aged between 5.2 years and 16 years). Signs of aorto-mesenteric left renal vein entrapment were noted in 18 of the 24 subjects. In conclusion, aorto-mesenteric left renal vein entrapment is common also among European subjects with postural proteinuria.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Vehaskari VM (1990) Mechanism of orthostatic proteinuria. Pediatr Nephrol 4:328–330

    CAS  PubMed  Google Scholar 

  2. Wingo CS, Clapp WL (2000) Proteinuria: potential causes and approach to evaluation. Am J Med Sci 320:188–194

    CAS  PubMed  Google Scholar 

  3. Shintaku N, Takahashi Y, Akaishi K, Sano A, Kuroda Y (1990) Entrapment of left renal vein in children with orthostatic proteinuria. Pediatr Nephrol 4:324–327

    CAS  PubMed  Google Scholar 

  4. Lee SJ, You ES, Lee JE, Chung EC (1997) Left renal vein entrapment syndrome in two girls with orthostatic proteinuria. Pediatr Nephrol 11:218–220

    CAS  PubMed  Google Scholar 

  5. Cho BS, Choi YM, Kang HH, Park SJ, Lim JW, Yoon TY (2001) Diagnosis of nut-cracker phenomenon using renal Doppler ultrasound in orthostatic proteinuria. Nephrol Dial Transplant 16:1620–1625

    CAS  PubMed  Google Scholar 

  6. Park SJ, Lim JW, Cho BS, Yoon TY, Oh JH (2002) Nutcracker syndrome in children with orthostatic proteinuria: diagnosis on the basis of Doppler sonography. J Ultrasound Med 21:39–45

    PubMed  Google Scholar 

  7. Ekim M, Bakkaloglu SA, Tumer N, Sanlidilek U, Salih M (1999) Orthostatic proteinuria as a result of venous compression (nutcracker phenomenon)—a hypothesis testable with modern imaging techniques. Nephrol Dial Transplant 14:826–827

    CAS  PubMed  Google Scholar 

  8. Ekim M, Ozçakar ZB, Fitoz S, Soygür T, Yüksel S, Acar B, Yalçinkaya F, Arikan N (2006) The “nutcracker phenomenon” with orthostatic proteinuria: case reports. Clin Nephrol 65:280–283

    CAS  PubMed  Google Scholar 

  9. Barbey F, Venetz JP, Calderari B, Nguyen QV, Meuwly JY (2003) Protéinurie orthostatique et phénomène de compression de la veine rénale gauche (nutcracker syndrome). Presse Med 31:883–885

    Google Scholar 

  10. Ahmed K, Sampath R, Khan MS (2006) Current trends in the diagnosis and management of renal nutcracker syndrome: a review. Eur J Vasc Endovasc Surg 31:410–416

    CAS  PubMed  Google Scholar 

  11. Shin JI, Lee JS (2005) Nutcracker phenomenon or nutcracker syndrome? Nephrol Dial Transplant 20:2015

    PubMed  Google Scholar 

  12. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114:555–576

    Google Scholar 

  13. Ogden CL, Kuczmarski RJ, Flegal KM, Mei Z, Guo S, Wei R, Grummer-Strawn LM, Curtin LR, Roche AF, Johnson CL (2002) Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics 109:45–60

    PubMed  Google Scholar 

  14. Ha TS, Lee EJ (2006) ACE inhibition can improve orthostatic proteinuria associated with nutcracker syndrome. Pediatr Nephrol 21:1765–1768

    PubMed  Google Scholar 

  15. Shin JI, Lee JS (2007) ACE inhibition in nutcracker syndrome with orthostatic proteinuria: how about a hemodynamic effect? Pediatr Nephrol 22:758

    PubMed  Google Scholar 

  16. Ha TS, Lee EJ (2007) ACE inhibition in orthostatic proteinuria associated with nutcracker syndrome would be individualized. Pediatr Nephrol 22:759–760

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Emilio F. Fossali.

Additional information

Monica Ragazzi and Gregorio Milani contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ragazzi, M., Milani, G., Edefonti, A. et al. Left renal vein entrapment: a frequent feature in children with postural proteinuria. Pediatr Nephrol 23, 1837–1839 (2008). https://doi.org/10.1007/s00467-008-0909-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-008-0909-8

Keywords

Navigation