[Neonatal renal venous thrombosis: the recent experience of Robert-Debré hospital]

Neonatal renal venous thrombosis (NRVT) is a rare disease, with variable consequences on kidney function. We report a retrospective study of 9 newborns with NRVT admitted to our hospital from 1996 to 2005. The median age at diagnosis was 2 days (range, 1-10 days). In 7 patients, diagnosis was suspected based on one classical clinical or biological sign and was confirmed by ultrasound. Seven newborns had at least one known obstetrical or neonatal risk factor. NRVT was unilateral in three cases, was bilateral in 6 cases, and was associated with inferior vena cava thrombosis in 5 patients, with surrenal hemorrhage in 3 patients. Three patients did not receive specific treatment. The median delay between diagnosis and specific treatment was 20 h (range, 3-36 h). Three patients were treated by fibrinolysis, including 2 with bilateral NRVT, 2 newborns received heparins, and 1 patient was treated with a vitamin K antagonist. With a median evaluation time of 5 years and 2 months for 6 patients, 5 patients recovered their kidney function completely and the 6th child has moderate renal failure. It seems illusory to wait for randomized control studies to appreciate the potential long-term benefit of treatments on kidney function after a NRVT, whose bilateral forms appear to be more severe. A case-by-case approach appears better adapted. These results reinforce recommendations that suggest an early pediatric nephrologic follow-up for all newborns with a NRVT.