Renal venous thrombosis in neonates

Area of Science:

• Pediatric Nephrology
• Neonatal Medicine
• Vascular Thrombosis

Background:

• Neonatal renal vein thrombosis (RVT) is a significant cause of morbidity in newborns.
• Approximately 80% of RVT cases manifest within the first postnatal month.
• Identified risk factors include birth asphyxia, infant of a diabetic mother, volume contraction, and coagulation disorders.

Purpose of the Study:

• To summarize the clinical presentation, diagnostic approaches, and management strategies for neonatal renal vein thrombosis.
• To highlight the potential long-term sequelae of RVT.

Main Methods:

• Review of clinical characteristics, risk factors, diagnostic findings, and treatment modalities for neonatal RVT.
• Emphasis on diagnostic imaging (renal ultrasound with Doppler) and the gold standard (renal venography).

Main Results:

• The classic triad of RVT includes gross hematuria, flank mass, and thrombocytopenia.
• Laboratory findings may indicate hematuria, proteinuria, polycythemia, hemolytic anemia, and acute kidney injury.
• Renal ultrasound findings include kidney enlargement and altered echogenicity; renal venography is definitive.

Conclusions:

• Supportive care, fluid/electrolyte correction, and treatment of underlying conditions are primary management steps.
• Anticoagulation with unfractionated heparin (UFH) or low molecular weight heparin (LMWH) is considered for disseminated intravascular coagulation.
• RVT poses risks for developing hypertension and chronic kidney disease in affected infants.