The clinical spectrum of renal vein thrombosis: Acute and chronic

https://doi.org/10.1016/S0002-9343(80)80006-4Get rights and content

The present study is a prospective evaluation of 151 patients with the nephrotic syndrome in regard to the incidence of renal vein thrombosis, modes of clinical presentation, pathogenetic course and response to anticoagulant therapy. Of the 151 nephrotic patients studied, 33 had renal vein thrombosis and membranous nephropathy was present in 20. There were two modes of clinical presentation: (1) a sudden renal vein thrombosis was observed in the young patient with acute flank pain, marked costovertebral angle tenderness and macroscopic hematuria; a characteristic intravenous pyelogram, renal histologic changes and anticoagulant therapy were followed by marked improvement in renal function; (2) long-term renal vein thrombosis was observed in the older patients; they were asymptomatic and intravenous pyelograms disclosed no abnormalities; there were no suggestive renal histologic findings; the incidence of thromboembolic phenomena other than renal vein thrombosis was high, and there was mild progressive deterioration of renal function which was not altered by anticoagulant drugs; treated nephrotic patients with chronic renal vein thrombosis did not experience a new episode of thromboembolism whereas untreated nephrotic patients without renal vein thrombosis did. Finally, the sequence of nephrotic syndrome leading to renal vein thrombosis was clearly established showing the pathogenetic role of the nephrotic syndrome in renal vein thrombosis. Possible mechanisms in the pathogenesis of renal vein thrombosis are also discussed.

References (38)

  • RobinsonG

    Researches into the correction existing between an immaterial degree of compression of the blood contained in the renal vessels and the presence of certain abnormal matters in the urine

    Med Clin Trans

    (1843)
  • DerowHA et al.

    Chronic progressive occlusion of the inferior vena cava and the renal and portal veins with the clinical picture of nephrotic syndrome. Report of a case with a review of the literature

    Arch Intern Med

    (1939)
  • SchreinerGI
  • LlachF et al.

    Renal vein thrombosis and nephrotic syndrome: a prospective study of 36 adult patients

    Ann Intern Med

    (1975)
  • LlachF et al.

    On the incidence of renal vein thrombosis in the nephrotic syndrome

    Arch Intern Med

    (1977)
  • LlachF et al.

    Renal vein thrombosis and the nephrotic syndrome

    Nephron

    (1977)
  • KanferA et al.

    Coagulation studies in 45 cases of nephrotic syndrome without uremia

    Thromb Diathes Haemorrh

    (1970)
  • KendallAG et al.

    Nephrotic syndrome: a hypercoagulable state

    Arch Intern Med

    (1971)
  • ThompsonC et al.

    Changes in blood coagulation and fibrinolysis in the nephrotic syndrome

    Q J Med

    (1974)
  • Cited by (195)

    • Thromboembolism in nephrotic syndrome: controversies and uncertainties

      2023, Research and Practice in Thrombosis and Haemostasis
    • Nonneoplastic Diseases of the Kidney

      2020, Urologic Surgical Pathology
    • Thrombosis of the venous vasculature: Diagnosis and management

      2018, Cardiovascular Thrombus: From Pathology and Clinical Presentations to Imaging, Pharmacotherapy and Interventions
    View all citing articles on Scopus
    View full text