Fibrinolytic therapy for renal vein thrombosis in the child

Renal vein thrombosis may lead to significant renal impairment, even death, yet therapy remains controversial. Thrombolytic therapy in general may be attended by significant hemorrhagic complications and has not been used widely in children. We treated a 9-year-old boy with antithrombin III deficiency and acute renal vein thrombosis in a solitary kidney with a selective 48-hour infusion of low dose urokinase with return of renal function. Minor bleeding from a fresh surgical incision was the only morbidity. Such use of fibrinolytic agents in children with acute renal vein thrombosis may prevent significant renal impairment and deserves further clinical trials.