Neonatal Renal Vein Thrombosis: Review of the English-Language Literature Between 1992 and 2006

Renal vein thrombosis is a complication that occurs in neonates with various underlying risk factors. It carries a grave prognosis for affected kidneys. Anticoagulant and fibrinolytic therapies have been promoted in the past with anecdotal success in some circumstances. However, prospective controlled trials are still lacking, and to date there have been no evidence-based guidelines available for the treatment of neonates with renal vein thrombosis. We retrospectively reviewed all the available medical literature pertaining to renal vein thrombosis published in English during the past 15 years. A total of 271 patients from 13 case series were identified by using the terms “renal vein thrombosis” and “neonates” via PubMed and Cochrane Library searches. Data then were extracted from each of the studies for analysis. During the past 15 years, a male predominance (67.2%) in neonatal renal vein thrombosis has been reported. More than 70% of patients had unilateral renal vein thrombosis, which was more prevalent on the left side (63.6%). The thrombus involved the inferior vena cava and was associated with adrenal hemorrhage in 43.7% and 14.8% of neonates, respectively. Forty percent of the patients were treated conservatively with supportive care alone. Among those patients who received anticoagulation therapy, unfractionated heparin and low molecular weight heparin were used alone in 21.6% and 20.7% of the patients, respectively. Fibrinolytic treatment alone was used in 11.2% of the patients. Only a minority of patients were treated with antithrombin (1.7%), warfarin alone, (0.9%) or underwent surgical intervention (0.3%). The majority (70.6%) of the involved kidneys became atrophic. A total of 9 neonates died with non–renal vein thrombosis–related conditions during the study period. Evidence-based recommendations on treatment cannot be made at the present time. Cooperative prospective studies that involve multiple centers are needed to elucidate the optimal treatment for neonatal renal vein thrombosis.

[1]  A. Sinaiko,et al.  Renal Outcome of Neonatal Renal Venous Thrombosis: Review of 28 Patients and Effectiveness of Fibrinolytics and Heparin in 10 Patients , 2006, Pediatrics.

[2]  M. Mihatsch,et al.  Bilateral renal vein thrombosis in a twin newborn without known risk factors. , 2006, Clinical Nephrology.

[3]  A. Wade,et al.  Perinatal renal venous thrombosis: presenting renal length predicts outcome , 2006, Archives of Disease in Childhood - Fetal and Neonatal Edition.

[4]  A. Morikawa,et al.  Percutaneous Hydrodynamic Thrombectomy for Congenital Deep Vein Thrombosis in a Neonate , 2006, Pediatric Cardiology.

[5]  N. Rosenblum,et al.  Neonatal renal venous thrombosis: clinical outcomes and prevalence of prothrombotic disorders. , 2005, The Journal of pediatrics.

[6]  N. Wright,et al.  Antenatal and neonatal renal vein thrombosis: New ultrasonic features with high frequency transducers , 1996, Pediatric Radiology.

[7]  M. Er̀rington,et al.  The rare association of right adrenal haemorrhage and renal vein thrombosis diagnosed with duplex ultrasound , 2005, Pediatric Radiology.

[8]  J. Fishman,et al.  Renal vein thrombosis in utero: Duplex sonography in diagnosis and follow-up , 1994, Pediatric Radiology.

[9]  C. Van Geet,et al.  Thrombophilia in neonatal renal venous and arterial thrombosis , 2005, Pediatric Nephrology.

[10]  F. Eke,et al.  Renal vein thrombosis in the neonate: a case report and review of the literature. , 2004, Journal of the National Medical Association.

[11]  K. Kurnik,et al.  Renal venous thrombosis in neonates: prothrombotic risk factors and long-term follow-up. , 2004, Blood.

[12]  S. Kuhle,et al.  A case series of 72 neonates with renal vein thrombosis , 2004, Thrombosis and Haemostasis.

[13]  S. Saint,et al.  Index of Suspicion , 2004, Pediatrics In Review.

[14]  M. Andrew,et al.  Hemostatic complications in renal disorders of the young , 1996, Pediatric Nephrology.

[15]  G. Lin,et al.  Neonatal renal venous thrombosis—a case report describing serial sonographic changes , 1994, Pediatric Nephrology.

[16]  G. Vartholomatos,et al.  Renal venous thrombosis in an infant with predisposing thrombotic factors: color Doppler ultrasound and MR evaluation , 2003, European Radiology.

[17]  D. Batisky,et al.  INDEX OF SUSPICION , 1995, Pediatrics In Review.

[18]  Chien-Hsing Lee.  Intestinal obstruction caused by infarcted splenic hemangioma with renal vein thrombosis in a newborn: a case report. , 2002, International surgery.

[19]  J. Fiascone,et al.  Combination thrombolytic and anticoagulant therapy for bilateral renal vein thrombosis in a premature infant. , 2001, American journal of perinatology.

[20]  A. Murphy,et al.  Renal venous thrombosis with calcification and preservation of renal function , 2001, Pediatric Radiology.

[21]  A. von Eckardstein,et al.  Risk of recurrent venous thrombosis in children with combined prothrombotic risk factors. , 2001, Blood.

[22]  A. Iolascon,et al.  Renal vein thrombosis in a newborn with prothrombotic genetic risk factors , 2001, Journal of perinatal medicine.

[23]  D. Wheeler,et al.  Radiological case of the month. Inferior vena cava and renal vein thrombosis in a neonate. , 2001, Archives of pediatrics & adolescent medicine.

[24]  R. Junker,et al.  Abdominal venous thrombosis in neonates and infants: role of prothrombotic risk factors - a multicentre case-control study. For the Childhood Thrombophilia Study Group. , 2000 .

[25]  R. Junker,et al.  Abdominal venous thrombosis in neonates and infants: role of prothrombotic risk factors – a multicentre case–control study , 2000, British journal of haematology.

[26]  S. Emil,et al.  Renal vein thrombosis: a 10-year review. , 2000, Journal of pediatric surgery.

[27]  K. Suga,et al.  Coexisting renal vein thrombosis and bilateral adrenal hemorrhage: renoscintigraphic demonstration. , 2000, Clinical nuclear medicine.

[28]  R. von Kries,et al.  Neonatal renal venous thrombosis in Germany between 1992 and 1994: epidemiology, treatment and outcome , 2000, European Journal of Pediatrics.

[29]  J. Anguenot,et al.  Antenatal renal vein thrombosis after accidental electric shock in a pregnant woman. , 1999, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[30]  E. Macías,et al.  Tc-99m MAG3 scintigraphy in a newborn with acute renal vein thrombosis. , 1999, Clinical nuclear medicine.

[31]  J. Scharf,et al.  Selective thrombolysis in a newborn with bilateral renal venous and cerebral thrombosis and heterozygous APC resistance. , 1998, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[32]  R. Schild,et al.  Hereditary thrombophilia in a family with three independent protein S and C mutations. A cause of adverse perinatal outcome. , 1998, European Journal of Obstetrics, Gynecology, and Reproductive Biology.

[33]  A. Daneman,et al.  Asymmetric medullary nephrocalcinosis in two children , 1998, Pediatric Radiology.

[34]  J. Rozé,et al.  Renal venous thrombosis: an unusual cause of fetal distress. , 1998, European journal of obstetrics, gynecology, and reproductive biology.

[35]  J. Radhakrishnan,et al.  Renal vein thrombosis secondary to absent inferior vena cava. , 1998, Urology.

[36]  F. Heinen,et al.  Bilateral renal vein thrombosis and venous sinus thrombosis in a neonate with factor V mutation (FV Leiden). , 1998, The Journal of pediatrics.

[37]  M. Cendron,et al.  Bilateral renal vein thrombosis in a newborn: a case of prenatal renal vein thrombosis. , 1997, Urology.

[38]  D. Haffner,et al.  Bilateral renal venous thrombosis in a neonate associated with resistance to activated protein C , 1996, Pediatric Nephrology.

[39]  D. Cooper,et al.  Severe perinatal thrombosis in double and triple heterozygous offspring of a family segregating two independent protein S mutations and a protein C mutation. , 1996, Blood.

[40]  B. Schmidt,et al.  Neonatal thrombosis: report of a prospective Canadian and international registry. , 1995, Pediatrics.

[41]  Ashok Kumar,et al.  Recovery from bilateral renal vein thrombosis on supportive management alone , 1995, Indian Journal of Pediatrics.

[42]  B. Reichman,et al.  Early neonatal renal venous thrombosis: long‐term outcome , 1994, Acta paediatrica.

[43]  M. Tulli,et al.  Tc‐99m MAG3 Renography in Renal Vein Thrombosis Secondary to Finnish‐Type Congenital Nephrotic Syndrome , 1994, Clinical Nuclear Medicine.

[44]  J. Bowie,et al.  Fetal renal vein thrombosis, hydrops fetalis, and maternal lupus anticoagulant. A case report , 1994, Prenatal diagnosis.

[45]  M. Manco-Johnson,et al.  Efficacy and safety of heparin anticoagulation for neonatal renal vein thrombosis. , 1994, The American journal of pediatric hematology/oncology.

[46]  J. Pracros,et al.  Coexisting calcified inferior vena cava thrombus and adrenal hemorrhage in the neonate: Report of three cases , 1994, Journal of clinical ultrasound : JCU.

[47]  T. Krummel,et al.  Recombinant tissue plasminogen activator for neonatal and pediatric vascular thrombolytic therapy. , 1993, Journal of pediatric surgery.

[48]  D. Filiatrault,et al.  Renal vein thrombosis in children: evidence of early flow recovery with Doppler US. , 1993, Radiology.

[49]  D. Mitchell,et al.  Rapid diagnosis of neonatal renal vein thrombosis using color Doppler imaging , 1993, Journal of clinical ultrasound : JCU.

[50]  M. Siegel,et al.  Special imaging casebook. Neonatal adrenal hemorrhage and renal vein thrombosis. , 1993, Journal of Perinatology.

[51]  P. Lund,et al.  Case of the day. Renal vein and inferior vena cava thrombosis in a newborn , 1993, Journal of ultrasound in medicine.

[52]  G. Fariello,et al.  Renal vein thrombosis and adrenal hemorrhage in the newborn: Ultrasound evaluation of 4 cases , 1993, Journal of clinical ultrasound : JCU.

[53]  C. Matos,et al.  Calcified inferior vena cava thrombus in a fetus: perinatal imaging , 1993, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[54]  W. Kreuz,et al.  Thrombolysis with recombinant tissue-type plasminogen activator in renal venous thrombosis in infancy , 1992, The Lancet.

[55]  M. Hiatt,et al.  Neonatal Thrombosis with Anticardiolipin Antibody in Baby and Mother , 1992, American journal of perinatology.

[56]  L. Feld,et al.  Coexistence of Renal Vein Thrombosis and Adrenal Hemorrhage in Two Newborns , 1992, Clinical pediatrics.