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Renal Vein Thrombosis
Renal vein thrombosis is the formation of a thrombus in the renal vein with the risk of acute renal failure.
Etiology (Causes) of Renal Vein Thrombosis
- Nephrotic syndrome
- Thrombophilia syndromes
- Compression of renal vein by retroperitoneal tumors or other retroperitoneal diseases
- Severe dehydration
- Newborns or infants: Risk factors for renal vein thrombosis include perinatal asphyxia or hypotension and cyanotic heart diseases
Signs and Symptoms
- Flank pain
- Painful flank tumor by renal enlargement may be possible
- Acute renal failure: decreased urine production (oliguria/anuria)
Diagnostic Work-Up of Renal Vein Thrombosis
Urine analysis: hematuria and proteinuria. Blood tests: eventually increased creatinine and potassium in serum.
Renal ultrasound is important for differential diagnosis of acute renal failure: e.g. exclusion of hydronephrosis. Signs of renal vein thrombosis are kidney enlargement and the detection of a renal vein thrombus in Doppler sonography. The renal vein thrombus may extend into the inferior vena cava.
CT or MRI Abdomen:
CT or MRI of the abdomen can reliably proof renal vein thrombosis.
Treatment of Renal Vein Thrombosis
- Immediate parenteral anticoagulation with heparin
- After the acute phase, oral anticoagulation with e.g. warfarin is necessary. The duration depends on the risk profile and the remaining renal function
- Treatment of the underlying disease (e.g. nephrotic syndrome)
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Deutsche Version: Nierenvenenthrombose