Renal Venous Occlusion
Renal vein occlusion is a thrombotic event. The incidence of renal vein thrombosis (RVT) is high in nephrotic glomerulopathies, especially membranous nephropathy, and in certain neoplastic diseases. Renal vein thrombosis may occur in children who develop severe volume depletion accompanying a gastrointestinal disorder.
Renal vein thrombosis most often occurs in the absence of direct clinical symptoms. However, two distinct patterns of clinical presentation have been recognized. Acute renal failure is often seen in children or in patients with the nephrotic syndrome who have a reduced but stable baseline GFR. The second mode of presentation is that of acute pulmonary embolism and infarction, seen most often in patients with the nephrotic syndrome.
Renal vein thrombosis can often be diagnosed safely with renal ultrasonography, but renal venography may be required for definitive diagnosis in some patients. Prophylactic anticoagulant therapy in patients with nephrotic glomerulopathies, the group at highest risk for RVT, is not of proven use. Acute anticoagulant therapy is indicated in cases of proven or threatened pulmonary embolism; an improvement in renal function may occur.