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Also Known as
Kidney Blood Clot or Blockage of Renal Vein
Description
Renal Vein Thrombosis refers to the Blockage of Renal Vein (carries oxygen-depleted blood away from the kidney) by a blood clot (thrombus).
Symptoms
- May be mild or absent
- Some patients present with shortness of breath due to a clot in the lung (i.e., pulmonary embolus).
- If it occurs suddenly :
- Back or flank pain (pain in the upper back to the sides)
- Hematuria or Blood in the Urine
- Low urine volume
Causes
- Blood clots form when normally liquid blood thickens, or its flow slows down and becomes stagnant.
- Causes of blood clot formation :
- Trauma to back or abdomen will damage the vein or scar it, and slow the normal blood flow.
- Malignant (invasive/cancer) renal tumors such as Renal Cell Carcinomas can invade the vein and cause blockage to blood flow.
- External compression of the vein from pregnancy, tumors of the abdomen, or narrowing or strictures of the major vein known as the inferior vena cava.
- Nephrotic Syndrome -- membranous glomerulonephropathy
- Dehydration in infants
How the Diagnosis is made
- History of symptoms, illnesses, past history of Thrombosis, allergies, medications, surgeries (especially abdominal or vascular), family history, and habits
- Medical exam may reveal flank or back pain.
- Urinalysis under a microscope may reveal red blood cells.
- Blood tests may reveal high levels of kidney chemical known as LDH enzyme.
- X-Ray, Ultrasound, MRI or CAT scan are radiographic techniques that can show the size (often enlarged kidney), structure, and clot location in the kidneys.
- Venography, done by injecting a dye (coloring) into the veins and then X-Raying the area, can show the location of the renal vein narrowing or clotting.
Risk factors
- See causes
- Problems with substances that alter blood viscosity (fluidity):
- Platelets abnormalities
- Increased Fibrinogen levels
- Decreased Antithrombin III
- Protein C and S deficiency
- Anticardiolipin syndrome
- Oral contraceptives
- Estrogen therapy
- Thrombophlebitis migrans
Treatment
- Hydration with intravenous fluids may help.
- Thinning the blood first with Heparin (intravenously) and then orally with Warfarin pills, which may need to be continued.
- Surgical removal of the clot (thrombectomy), removal of the infarcted kidney (nephrectomy), or inserting a flexible tube to reopen the blocked vein (recanalization ) are other options.
Complications
- Renal failure can occur.
- Renal infarction -- the segment of kidney dies
- Pulmonary Emboli can occur.
- Death is rare
Similar conditions
- Nephrotic Syndrome
- Pyelonephritis
- Herniated Disc
- Pulmonary Emboli
- Kidney Stones
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