Incidence, Risk Factors, and Outcomes of Neonatal Renal Vein Thrombosis in Ontario: Population-Based Cohort Study

Abstract

BackgroundThere are limited data at a population level on the burden, risk factors, and long-term outcomes of neonatal renal vein thrombosis (nRVT). We conducted a population-based cohort study to understand the epidemiology and outcomes of nRVT over a 25-year period in Ontario.MethodsUsing linked administrative health databases, all hospitalized neonates ≤28 days born in Ontario between 1992 and 2016 with nRVT were identified. The primary outcome was to calculate the incidence of nRVT and trend over time in Ontario. We also determined the risk factors associated with nRVT as well as the risk of long-term outcomes after nRVT, including CKD, ESKD, all-cause mortality, and hypertension (HTN) compared with the healthy neonatal population without nRVT.ResultsThe annual incidence rate of nRVT was 2.6 per 100,000 live births (n=85). Presence of respiratory distress syndrome (OR, 8.01; 95% CI, 4.90 to 13.1), congenital heart disease (OR, 9.1; 95% CI, 5.05 to 16.4), central venous catheterization (OR, 3.9; 95% CI, 1.89 to 7.93), maternal preeclampsia (OR, 2.8; 95% CI, 1.6 to 4.79), and maternal diabetes (OR, 2.36; 95% CI, 1.36 to 4.07) conferred the highest risk for nRVT. Over a median follow-up of 15 years and after adjusting for confounders, neonates with nRVT versus the comparator cohort had a 15.5-fold risk of CKD, HTN, or death (n=49 [58%] versus n=90,050 [3%]; 95% CI, 11.7 to 20.6); 12.3-fold increased risk of CKD or death (n=39 [46%] versus n=32,016 [1%]; 95% CI, 8.9 to 16.8); and a 15.7-fold increased risk of HTN (n=33 [39%] versus n=64,458 [2%]; 95% CI, 11.1 to 21.1). None of the nRVT cohort developed ESKD. The median time to composite outcome of CKD, HTN, or death was 11.1 years.ConclusionsPatients with a history of nRVT remain at higher risk than the general population for long-term morbidity or mortality, indicating the need for long-term follow-up.

Outcomes in infants with unprovoked venous thromboembolism: A retrospective cohort study

“…We also demonstrated poor outcomes after RVT. Two-thirds of infants with a prior RVT and outpatient nephrology follow-up had decreased kidney function, which is consistent with prior literature demonstrating increased risk of CKD after neonatal RVT [ 17 ]. These poor outcomes may be confounded by more data being available for those with more severe disease; however, outpatient data were available for >80% of infants with either RVT or intracranial thrombosis.…”

Cancer-Associated Abdominal Vein Thrombosis

“…RVT is a rare medical condition, with an incidence rate of ≤0.1 cases per 100,000 persons per year in the general population [51]. It more commonly arises in neonates, in whom the annual incidence rate was reported to be 2.6 per 100,000 live births [52]. RVT is frequently associated with nephrotic syndrome and is detected in 5-62% of patients with this condition [53].…”

Modern Aspects of Anticoagulation System Disorders Diagnosis in Children with Different Polymorphisms in Coagulation Genes. Initial Results

“…Их основной причиной являются физиологические особенности системы гемостаза новорожденных (снижение активности фибринолитической системы и ЕАК в 2-3 раза от нормальных значений на первом году жизни, а также активация внутреннего пути свертывания крови) [7,8]. В структуре тромботических событий в детском возрасте, по данным некоторых исследований, тромбозы портальных вен составляют 22-75% [9][10][11], церебральных вен -18-51% [12], вен сердца -5% [13], почечных вен -10% [4,14], вен конечностей -3-63% [15]. На артериальные тромбозы приходится 5,18% [16].…”