nach oben

Journal of Nephrology

Erschienen in:

13.09.2023 | original Article

Risk factors of worsening kidney function and mortality in patients with renal vein thrombosis: a retrospective study

verfasst von: Puttinat Wanaratwichit, Chatree Chai-Adisaksopha, Nakarin Inmutto, Kajohnsak Noppakun

Erschienen in: Journal of Nephrology | Ausgabe 1/2024

Einloggen, um Zugang zu erhalten

Abstract

Background

The outcome of renal vein thrombosis, in particular as for the long-term impact on kidney function, is not fully known. We aimed to study the natural course and outcomes of patients with renal vein thrombosis, in a large, single-center cohort.

Methods

A single-center retrospective cohort study including patients who were diagnosed with renal vein thrombosis between January 2006 and September 2021 was analyzed. The main outcomes analyzed were worsening kidney function, defined as a decrease in eGFR of at least 40% from baseline, and all-cause mortality.

Results

Eighty-seven patients were included, 56.3% were female, median age was 57 years. Malignancy was the most common cause of renal vein thrombosis (60.9%), followed by post-surgery and trauma (16.1%) and nephrotic syndrome (12.6%). At initial presentation, 65.5% of the patients were asymptomatic; the main signs and symptoms were gross hematuria (20.7%), flank pain (18.4%), and flank tenderness (9.2%). During follow-up, 18 (21.4%) patients experienced worsening kidney function and 57 (65.5%) died. Multivariable analyses showed that the risk of worsening kidney function was higher in patients with nephrotic syndrome (hazard ratio [HR] 18.41; 95% confidence interval [CI], 1.57–216.04), body weight ≥ 60 kg (HR 4.82; 95% CI 1.43–16.32), and malignancy (HR 9.10; 95% CI 1.05–78.63). Symptomatic acute renal vein thrombosis was associated with a lower risk of worsening kidney function compared to asymptomatic or symptomatic chronic renal vein thrombosis (HR 0.12; 95% CI 0.01–0.96). Malignancy (HR 5.45; 95% CI 2.58–11.54), age ≥ 75 years (HR 3.44; 95% CI 1.49–7.93), and serum albumin < 3.0 g/dL (HR 2.88; 95% CI 1.65–5.05) were associated with an increased mortality risk.

Conclusion

Renal vein thrombosis is associated with a high rate of worsening kidney function and mortality. It is crucial to promptly identify patients at high risk and initiate early treatment to prevent negative outcomes.

Graphical abstract

Nur mit Berechtigung zugänglich

Asghar M, Ahmed K, Shah SS, Siddique MK, Dasgupta P, Khan MS (2007) Renal vein thrombosis. Eur J Vasc Endovasc Surg 34(2):217–223. https://doi.org/10.1016/j.ejvs.2007.02.017CrossRefPubMed

Bagot CN, Arya R (2008) Virchow and his triad: a question of attribution. Br J Haematol 143(2):180–190. https://doi.org/10.1111/j.1365-2141.2008.07323.xCrossRefPubMed

Tavakkoli M, Zafarghandi RM, Taghavi R, Ghoreifi A, Zafarghandi MM (2017) Immediate vascular complications after kidney transplant: experience from 2100 recipients. Exp Clin Transplant 15(5):504–508. https://doi.org/10.6002/ect.2016.0057CrossRefPubMed

Date Y, Nagamine H, Hara H, Kawase Y (2019) Renal vein thrombosis after open repair of abdominal aortic aneurysm successfully treated by direct oral anticoagulants. Vasc Endovasc Surg 53(5):408–410. https://doi.org/10.1177/1538574419839251CrossRef

Ouellette AC, Darling EK, Sivapathasundaram B, Babe G, Perez R, Chan AKC, Chanchlani R (2020) Incidence, risk factors, and outcomes of neonatal renal vein thrombosis in Ontario: population-based cohort study. Kidney360 1(7):640–647. https://doi.org/10.34067/kid.0000912019CrossRefPubMedPubMedCentral

Gozzo C, Farina R, Foti PV, Iannace FA, Conti A, Pennisi I, Santonocito S, Palmucci S, Basile A (2021) Posterior nutcracker syndrome: a case report. J Med Case Rep 15(1):42. https://doi.org/10.1186/s13256-020-02617-0CrossRefPubMedPubMedCentral

Lizama L, Bran S, Kuestermann S, García-Gallont R (2020) Renal vein thrombosis due to posterior nutcracker syndrome. Methodist Debakey Cardiovasc J 16(4):e5–e7. https://doi.org/10.14797/mdcj-16-4-e5CrossRefPubMedPubMedCentral

Ross O, Pourmoussa A, Batech M, Sim JJ (2017) Characteristics of patients diagnosed with renal vein thrombosis and glomerulopathy: a case series. Int Urol Nephrol 49(2):285–293. https://doi.org/10.1007/s11255-016-1442-5CrossRefPubMed

Wysokinski WE, Gosk-Bierska I, Greene EL, Grill D, Wiste H, McBane RD 2nd (2008) Clinical characteristics and long-term follow-up of patients with renal vein thrombosis. Am J Kidney Dis 51(2):224–232. https://doi.org/10.1053/j.ajkd.2007.10.030CrossRefPubMed

10.

Rottenstreich A, Barzilai M, Da’as N, Kleinstern G, Varon D, Kalish Y (2017) Active malignancy in patients with renal vein thrombosis: influence upon clinical course and survival. Clin Exp Nephrol 21(1):49–54. https://doi.org/10.1007/s10157-016-1245-0CrossRefPubMed

11.

Tektonidou MG (2018) Antiphospholipid syndrome nephropathy: from pathogenesis to treatment. Front Immunol 9:1181. https://doi.org/10.3389/fimmu.2018.01181CrossRefPubMedPubMedCentral

12.

El-Reshaid K, Al-Bader S, Sallam H (2016) Multiple visceral venous thromboses associated with oral contraceptive use. Saudi J Kidney Dis Transpl 27(6):1256–1259. https://doi.org/10.4103/1319-2442.194683CrossRefPubMed

13.

McCarthy LJ, Titus JL, Daugherty GW (1963) Bilateral renal-vein thrombosis and the nephrotic syndrome in adults. Ann Intern Med 58:837–857. https://doi.org/10.7326/0003-4819-58-5-837CrossRefPubMed

14.

Zubarev AV (2001) Ultrasound of renal vessels. Eur Radiol 11(10):1902–1915. https://doi.org/10.1007/s003300101012CrossRefPubMed

15.

Urban BA, Ratner LE, Fishman EK (2001) Three-dimensional volume-rendered CT angiography of the renal arteries and veins: normal anatomy, variants, and clinical applications. Radiographics 21(2):373–386. https://doi.org/10.1148/radiographics.21.2.g01mr19373CrossRefPubMed

16.

Kidney Disease: Improving Global Outcomes Glomerular Diseases Work G (2021) KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Kidney Int 100(4S):S1–S276. https://doi.org/10.1016/j.kint.2021.05.021CrossRef

17.

Inker LA, Eneanya ND, Coresh J, Tighiouart H, Wang D, Sang Y, Crews DC, Doria A, Estrella MM, Froissart M, Grams ME, Greene T, Grubb A, Gudnason V, Gutierrez OM, Kalil R, Karger AB, Mauer M, Navis G, Nelson RG, Poggio ED, Rodby R, Rossing P, Rule AD, Selvin E, Seegmiller JC, Shlipak MG, Torres VE, Yang W, Ballew SH, Couture SJ, Powe NR, Levey AS, Chronic Kidney Disease Epidemiology C (2021) New creatinine- and cystatin C-based equations to estimate GFR without race. N Engl J Med 385(19):1737–1749. https://doi.org/10.1056/NEJMoa2102953CrossRefPubMedPubMedCentral

18.

Kaatz S, Ahmad D, Spyropoulos AC, Schulman S, Subcommittee on Control of A (2015) Definition of clinically relevant non-major bleeding in studies of anticoagulants in atrial fibrillation and venous thromboembolic disease in non-surgical patients: communication from the SSC of the ISTH. J Thromb Haemost 13(11):2119–2126. https://doi.org/10.1111/jth.13140CrossRefPubMed

19.

Ruf W, Edgington TS (1994) Structural biology of tissue factor, the initiator of thrombogenesis in vivo. Faseb j 8(6):385–390CrossRefPubMed

20.

Falanga A, Panova-Noeva M, Russo L (2009) Procoagulant mechanisms in tumour cells. Best Pract Res Clin Haematol 22(1):49–60. https://doi.org/10.1016/j.beha.2008.12.009CrossRefPubMed

21.

Abdol Razak NB, Jones G, Bhandari M, Berndt MC, Metharom P (2018) Cancer-associated thrombosis: an overview of mechanisms, risk factors, and treatment. Cancers (Basel) 10(10):380. https://doi.org/10.3390/cancers10100380CrossRefPubMed

22.

Lechner D, Kollars M, Gleiss A, Kyrle PA, Weltermann A (2007) Chemotherapy-induced thrombin generation via procoagulant endothelial microparticles is independent of tissue factor activity. J Thromb Haemost 5(12):2445–2452. https://doi.org/10.1111/j.1538-7836.2007.02788.xCrossRefPubMed

23.

Zou PM, Li H, Cai JF, Chen ZJ, Li C, Xu P, Li MX, Chen LM, Li XM, Li XW (2018) A cohort study of incidences and risk factors for thromboembolic events in patients with idiopathic membranous nephropathy. Chin Med Sci J 33(2):91–99. https://doi.org/10.24920/11809CrossRefPubMed

24.

Singhal R, Brimble KS (2006) Thromboembolic complications in the nephrotic syndrome: pathophysiology and clinical management. Thromb Res 118(3):397–407. https://doi.org/10.1016/j.thromres.2005.03.030CrossRefPubMed

25.

van den Brand JA, van Dijk PR, Hofstra JM, Wetzels JF (2014) Long-term outcomes in idiopathic membranous nephropathy using a restrictive treatment strategy. J Am Soc Nephrol 25(1):150–158. https://doi.org/10.1681/ASN.2013020185CrossRefPubMed

26.

Laluck BJ Jr, Cattran DC (1999) Prognosis after a complete remission in adult patients with idiopathic membranous nephropathy. Am J Kidney Dis 33(6):1026–1032. https://doi.org/10.1016/s0272-6386(99)70138-1CrossRefPubMed

27.

Ryu S, Chang Y, Woo HY, Kim SG, Kim DI, Kim WS, Suh BS, Choi NK, Lee JT (2008) Changes in body weight predict CKD in healthy men. J Am Soc Nephrol 19(9):1798–1805. https://doi.org/10.1681/ASN.2007121286CrossRefPubMedPubMedCentral

28.

Olivo RE, Davenport CA, Diamantidis CJ, Bhavsar NA, Tyson CC, Hall R, Bidulescu A, Young B, Mwasongwe SE, Pendergast J, Boulware LE, Scialla JJ (2018) Obesity and synergistic risk factors for chronic kidney disease in African American adults: the Jackson Heart Study. Nephrol Dial Transplant 33(6):992–1001. https://doi.org/10.1093/ndt/gfx230CrossRefPubMed

29.

Zigman A, Yazbeck S, Emil S, Nguyen L (2000) Renal vein thrombosis: a 10-year review. J Pediatr Surg 35(11):1540–1542. https://doi.org/10.1053/jpsu.2000.18302CrossRefPubMed

30.

Soeters PB, Wolfe RR, Shenkin A (2019) Hypoalbuminemia: pathogenesis and clinical significance. JPEN J Parenter Enteral Nutr 43(2):181–193. https://doi.org/10.1002/jpen.1451CrossRefPubMed

Titel: Risk factors of worsening kidney function and mortality in patients with renal vein thrombosis: a retrospective study
verfasst von: Puttinat Wanaratwichit
Chatree Chai-Adisaksopha
Nakarin Inmutto
Kajohnsak Noppakun
Publikationsdatum: 13.09.2023
Verlag: Springer International Publishing
Erschienen in: Journal of Nephrology / Ausgabe 1/2024
Print ISSN: 1121-8428
Elektronische ISSN: 1724-6059
DOI: https://doi.org/10.1007/s40620-023-01761-2

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Risk factors of worsening kidney function and mortality in patients with renal vein thrombosis: a retrospective study

Abstract

Background

Methods

Results

Conclusion

Graphical abstract

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Blutdrucksenkung könnte Uterusmyome verhindern

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

Update Innere Medizin

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Background

Methods

Results

Conclusion

Graphical abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2024

Proteinuria reduction with SGLT2 inhibitors in a patient treated with tyrosine kinase inhibitor lenvatinib

Kidney function decline is associated with mortality events: over a decade of follow-up from Tehran Lipid and Glucose Study

Monogenic and polygenic concepts in chronic kidney disease (CKD)

Real world evaluation of kidney failure risk equations in predicting progression from chronic kidney disease to kidney failure in an Australian cohort

Urinary nephrin—a potential marker of early glomerular injury: a systematic review and meta-analysis

Improvements in digital pathology equipment for renal biopsies: updating the standard model

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Blutdrucksenkung könnte Uterusmyome verhindern

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

Update Innere Medizin