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Renal vein thrombosis: a 10-year review
1Département de Chirurgie, Hĵpital Sainte-Justine, and the Montreal Children's Hospital, Montreal, Quebec, Canada.
Journal of Pediatric Surgery
|November 18, 2000
Summary
Renal vein thrombosis (RVT) is more common in infants than expected. Early diagnosis and anticoagulation are crucial for improving renal outcomes in pediatric patients with RVT.
Area of Science:
- Pediatric Surgery
- Nephrology
- Vascular Medicine
Background:
- Renal vein thrombosis (RVT) is an uncommon cause of pediatric surgical consultation.
- Understanding the presentation and outcomes of RVT is essential for timely diagnosis and management.
Purpose of the Study:
- To review the experience with renal vein thrombosis (RVT) in Montreal during the 1990s.
- To identify risk factors, diagnostic challenges, and treatment outcomes for pediatric RVT.
Main Methods:
- Retrospective chart review of pediatric cases diagnosed between 1990 and 1999.
- Utilized Duplex ultrasound scan for diagnosis.
- Mean follow-up duration of 42 months.
Main Results:
- Twenty-three cases of RVT were identified, with 83% diagnosed within the first month of life.
- In utero thrombosis, associated with caval thrombosis and factor V Leiden, was suspected in 22%.
- Heparin anticoagulation was associated with improved long-term renal function compared to no anticoagulation (33% vs. 100% impairment).
Conclusions:
- RVT occurs more frequently than previously thought.
- The classic diagnostic triad is often absent; consider RVT in infants with risk factors presenting with flank mass, hematuria, or thrombocytopenia.
- Factor V Leiden is a risk factor for in utero RVT, and anticoagulation improves renal outcomes. Long-term follow-up is necessary.