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Renal vein thrombosis
or kidney blood clot
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- Renal Vein Thrombosis
refers to the blockage of the renal vein (carries
oxygen-depleted blood away from the kidney) by a blood clot
(thrombus).
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- 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
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- 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
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- 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.
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See causes
- Problems with substances that
alter blood viscosity (fluidity):
- Platelet abnormalities
- Increased Fibrinogen levels
- Decreased Antithrombin III
- Protein C and S deficiency
- Anticardiolipin syndrome
- Oral contraceptives
- Estrogen therapy
- Thrombophlebitis
migrans
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- 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.
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- Renal failure can occur.
- Renal infarction -- the segment of
kidney dies
- Pulmonary Emboli can occur.
- Death is
rare.
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