RENAL VEIN THROMBOSIS
Renal vein thrombosis is not a glomerulonephritis (no immunological injury), but discussed here for being an important d/d of gross hematuria and AGN.
Etiology: Renal vein thrombosis is seen with two distinct patterns - in newborns, associated with hypoxia, sepsis, dehydration or infants of diabetic mothers; and in older children, associated with cyanotic CHDs, nephrotic syndrome and inherited hypercoagulable states.
Thrombus formation usually begins in intra-renal vessels due to endothelial injury and stasis. Unilateral involvement is more common.Clinically, renal vein thrombosis usually presents with gross hematuria, flank pain and renal mass. Bilateral involvement may lead to acute kidney injury.
Diagnosis rests on clinical features (hematuria with flank pain/mass), predisposing factors and enlarged hypofunctioning kidney on USG and renal scan. Doppler studies or IVC venography are confirmative, though venographic studies should be avoided due to risk of further vascular damage.
Treatment is largely supportive for unilateral disease with fluid/electrolyte correction and control of infections. Unfractionated or low-molecular weight heparin therapy is indicated in bilateral disease or unilateral disease with IVC extension. Thrombosed kidney may recover gradually or undergo progressive atrophy. Renal scintigraphy is a sensitive screening test to assess evolution of renal dysfunction.
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More on the topic RENAL VEIN THROMBOSIS:
- RENAL VEIN THROMBOSIS
- Hepatic Vein Thrombosis
- Cerebral Venous Thrombosis
- DEEP VENOUS THROMBOSIS
- Atrial Thrombosis
- Renal Papillary Hyperplasia
- Renal Infarction
- HEREDITARY NEPHROPATHIES
- GLOMERULONEPHRITIS
- ACUTE KIDNEY INJURY