Renal Vein Thrombosis in Obese Patient

Son, Min Jeong; Lee, Ha Jeong; Oh, Kook Hwan; Joo, Kwon Wook; Kim, Sunhngwon

Abstract

Renal vein thrombosis (RVT) is mostly related with other causes. The underlying conditions of RVT were nephrotic syndrome, trauma, cancer, anatomical anomalies, and other hypercoagulable status. Especially hypercoagulable status was rarely caused by obesity. We diagnosed renal vein thrombosis from an obese patient with hypertriglyceridemia. A male patient visited the Seoul National University Hospital for evaluating the reason of his flank pain. The pain started from two weeks ago, He had regarded flank pain as his obesity status (his weight was 84 kg and Body mass index was 29.41 kg/m2). So he had lost his weight by over-sweating one day before. At initial examination, his blood pressure was 128/75 mmHg, pulse rate was 72/min, respiration rate was 20/min and body temperature was 36.2degrees C. Blood chemistries revealed total cholesterol 218 mg/dL, Blood urea nitrogen/creatinine 12/1.3 mg/dL Urinalysis showed specific gravity 1.015, pH 5.5, protein 2+, blood 2+, RBC/WBC 1-4/<1 HPF on microscopic examination. Twenty-four hour collection of the urine showed protein 329 mg/day, creatinine clearance 90 mL/min. Renal vein thrombosis was visualized on the renal computed tomography and pulmonary embolism on the lung scan. Then, anticoagulant therapy was started after coagulation related tests. However, no abnormality of coagulation tests was detected. The evidence of malignancy was not detected either. After anticoagulation therapy, the pain was subsided. The only underlying cause for his hypercoagulability was considered obese status. Unfortunately we had not checked the triglyceride, initially. So we could not prioritize the reason of renal vein thrombosis into hypertriyglyceridemia. We considered that his obese status and subsequent hypertriyglyceridemia might be one of the causes of renal vein thrombosis.