Renal vein obstruction and orthostatic proteinuria: a review

Mazzoni, M.; Kottanatu, Lisa; Simonetti, Giacomo D.; Ragazzi, Monica; Bianchetti, Mario G.; Fossali, Emilio F.; Milani, Gregorio P.

doi:10.1093/ndt/gfq444

Cited by 54 publications

(46 citation statements)

References 28 publications

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“…Orthostatic proteinuria is also reported, as caused by obstruction of left renal vein between abdominal aorta and superior mesenteric artery [8]. Although the exact mechanism of orthostatic proteinuria is not known, increased hemodynamic response and "subclinical immune injury" are the postulated mechanisms [4].…”

Section: Discussionmentioning

confidence: 99%

“…Although the exact mechanism of orthostatic proteinuria is not known, increased hemodynamic response and "subclinical immune injury" are the postulated mechanisms [4]. Other possible mechanisms include an increased physiologic response, subtle glomerular lesions with hemodynamic abnormality and an increase in release of norepinephrine and angiotensin II on standing up [8].…”

Section: Discussionmentioning

confidence: 99%

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The nutcracker syndrome: an underrecognized cause of hematuria

2012

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The nutcracker syndrome: an underrecognized cause of hematuria

2012

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“…The mechanism of orthostatic proteinuria was not well understood yet. Changes of renal hemodynamic and the elevated levels of norepinephrine and angiotensin II were thought as the causes [17] . Pain is a result of the inflammatory cascade triggered by venous hypertension.…”

Section: Clinical Featuresmentioning

confidence: 99%

Nutcracker syndrome

Gulleroglu

Gülleroğlu

Baskın

2014

WJN

130

163

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The nutcracker phenomenon [left renal vein (LRV) entrapment syndrome] refers to compression of the LRV most commonly between abdominal aorta and superior mesenteric artery. Term of nutcracker syndrome (NCS) is used for patients with clinical symptoms associated with nutcracker anatomy. LRV entrapment divided into 2 types: anterior and posterior. Posterior and right-sided NCSs are rare conditions. The symptoms vary from asymptomatic hematuria to severe pelvic congestion. Symptoms include hematuria, orthostatic proteinuria, flank pain, abdominal pain, varicocele, dyspareunia, dysmenorrhea, fatigue and orthostatic intolerance. Existence of the clinical features constitutes a basis for the diagnosis. Several imaging methods such as Doppler ultrasonography, computed tomography angiography, magnetic resonance angiography and retrograde venography are used to diagnose NCS. The management of NCS depends upon the clinical presentation and the severity of the LRV hypertension. The treatment options are ranged from surveillance to nephrectomy. Treatment decision should be based on the severity of symptoms and their expected reversibility with regard to patient's age and the stage of the syndrome.

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“…10 Imaging modalities such as selective left renal venography, ultrasound, computed tomography (CT), CT angiography, magnetic resonance (MR), MR angiography, and Doppler sonography can be used for diagnostic purposes although Doppler sonography is the first imaging modality with suspected NS which has a sensitivity of 78% and specificity of 100%. 11 The diagnostic measurements of NS are described by Zhang et al According to this study, the flow velocity of stenosis of the LRV in the supine position accelerates and this acceleration became more obvious when patient has stood for 15 min, the inner diameter ratio between the renal hilum and stenosis of LRV in the supine and upright position was >3 and >5 respectively. 12 Measurement of SMA angle is a very important criterion for the diagnosis of NS as well.…”

Section: Discussionmentioning

confidence: 74%

Clinico-radiological correlation of nutcracker syndrome: a single centre experience

Taktak

Acar

et al. 2017

Arch Argent Pediat

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The term nutcracker syndrome (NS) refers to the compression of left renal vein between the aorta and the superior mesenteric artery (SMA) causing renal venous hypertension. The symptoms vary from asymptomatic hematuria to severe pelvic congestion. The purpose of this study is to evaluate the clinical characteristics of patients with NS and the correlation between clinical and laboratory findings with Doppler sonographic measurements. Sixty-three patients were evaluated (19 boys and 44 girls) since January 2004 to January 2014. The mean age of the patients was 12.21 ± 3.21 years (range 7-17). Hematuria and proteinuria disappeared during the follow up of 9/63 patients. These nine patients showed statistically significant difference in upright SMA angles (p= 0.035). Doppler sonographic evaluation is a non-invasive method for diagnosis NS. Upright SMA angle measurement is more efficient than supine SMA angle measurement on clinicoradiological correlation.

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Renal vein obstruction and orthostatic proteinuria: a review

Abstract: These data provide substantial support for renal nutcracker as a common cause of orthostatic proteinuria.

Cited by 54 publications

References 28 publications

The nutcracker syndrome: an underrecognized cause of hematuria

The nutcracker syndrome: an underrecognized cause of hematuria

Nutcracker syndrome

Clinico-radiological correlation of nutcracker syndrome: a single centre experience

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