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[Orthostatic proteinuria and compression of the left renal vein (nutcracker syndrome)]
F Barbey1, J P Venetz, B Calderari
1Division de néphrologie, Centre hospitalier universitaire vaudois (CHUV), 17, av. Bugnon, 1011 Lausanne, Suisse. Frederic.Barbey@chuv.hos pvd.ch
Introduction:
The pathogenic mechanism of orthostatic proteinuria has not yet been clearly established.
Observation:
In a tall, thin, 21 year-old man, isolated proteinuria was discovered during an urological control conducted one year after a bilateral orchidopexy following left testicular torsion. Proteinuria was orthostatic. Doppler examination of the kidney revealed an entrapment of the left renal vein (nutcracker phenomenon-NCP).
Comments:
An NCP was diagnosed in a young patient presenting with orthostatic proteinuria. By provoking modifications in intraglomerular haemodynamics, the NCP may, in nearly half of the cases, be at the origin of orthostatic proteinuria. Doppler examination is the diagnostic method of choice in the screening for NCP.