Korean J Med.  2007 Oct;73(4):448-452.

Successful systemic thrombolysis of both the inferior vena cava and a renal vein thrombi that complicated nephrotic syndrome

• Lee HS
• Kim JT
• Min JW
• Kwon G
• Kim BS
• Choi GM
• Kang WH

Abstract

Nephrotic syndrome has been considered a hypercoagulable state because thromboembolic events of the venous or the arterial circulations occur on occasion. There are various risk factors for thromboembolism in patients with nephrotic syndrome (membranous nephropathy, severe hypoalbuminemia, hemoconcentration and medications such as steroid and diuretics). As thromboembolism is often fatal, early detection and proper management are important. Although anticoagulation is the preferred therapy, thrombolysis may be considered for an extensive thrombosis, for inferior vena cava (IVC) thrombosis, for recurrent pulmonary thromboembolism and for bilateral renal vein thrombosis in conjunction with acute renal failure. We report here on a case of renal vein and IVC thrombosis in a 24-year-old male with nephrotic syndrome, and this patient was treated with intravenous thrombolytics rather than anticoagulation and local thrombolytic infusion. He complained of left flank pain and his CT scan revealed left renal vein thrombosis and IVC thrombosis. After urokinase infusion, his thrombi were resolved successfully without bleeding complications.

Keyword

Thrombolysis; Thromboembolism; Nephrotic syndrome

MeSH Terms

Acute Kidney Injury
Flank Pain
Hemorrhage
Humans
Hypoalbuminemia
Male
Nephrotic Syndrome*
Pulmonary Embolism
Renal Veins*
Risk Factors
Thromboembolism
Thrombosis
Tomography, X-Ray Computed
Urokinase-Type Plasminogen Activator
Vena Cava, Inferior*
Young Adult
Urokinase-Type Plasminogen Activator