Skip to main content

Advertisement

SpringerLink
Log in

Renal vein thrombosis in neonates: a case series of diagnosis, treatment and childhood kidney function follow-up

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Background

Neonatal renal vein thrombosis (NRVT) is a rare condition with little data available.

Methods

We retrospectively analyzed newborns diagnosed with NRVT admitted to 3 pediatric nephrology units in Paris from 2005 to 2020.

Results

Twenty-seven patients were analyzed (male = 59%). The median age at diagnosis was 2.5 days (1 – 4.5). Diagnosis was suspected based on at least one of the three cardinal signs of renal vein thrombosis in 93%: flank mass (67%), hematuria (67%) and thrombocytopenia (70%). In all patients, diagnosis was confirmed by ultrasound. All patients had at least one known perinatal risk factor. A prothrombotic risk factor was found in 13 patients (48%). NRVT was unilateral in 70%, involving the left renal vein in 58%. Among 25 treated patients, 19 (76%) received low molecular weight heparin (LMWH) as initial therapy, 2 (8%) received unfractionated heparin and 4 (16%) received fibrinolysis. Median duration of treatment was 8 weeks (4 – 12). Bleeding occurred significantly more often with fibrinolysis than with LMWH/supportive therapy (3 of 4: 75% vs 0 of 4: 0%, p = 0.05). Clot resolution in patients treated with fibrinolysis did not differ significantly from those treated with LMWH/supportive therapy. After a median follow-up of 5.7 years (3 years – 9.9 years), pathological kidney features were observed in 73% of the patients (19 of 26), kidney atrophy in 18 (69%), hypertension in 2 (8%), chronic kidney disease (CKD) in 1 (4%) and proteinuria in 2 (8%).

Conclusions

NRVT remains a challenging condition, which still requires further study because of its associated morbidity.

Graphical abstract

A higher resolution version of the Graphical abstract is available as Supplementary information

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Kuhle S, Massicotte P, Chan A, Mitchell L (2004) A case series of 72 neonates with renal vein thrombosis. Data from the 1–800-NO-CLOTS Registry. Thromb Haemost 92:729–733. https://doi.org/10.1160/TH04-02-0131

    Article  CAS  PubMed  Google Scholar 

  2. Brandão LR, Simpson EA, Lau KK (2011) Neonatal renal vein thrombosis. Semin Fetal Neonatal Med 16:323–328. https://doi.org/10.1016/j.siny.2011.08.004

    Article  PubMed  Google Scholar 

  3. Kayemba-Kay’s S (2020) Spontaneous neonatal renal vein thrombosis, a known pathology without clear management guidelines: An overview. Int J Pediatr Adolesc Med 7:31–35. https://doi.org/10.1016/j.ijpam.2019.07.001

    Article  PubMed  Google Scholar 

  4. Ouellette AC, Darling EK, Sivapathasundaram B, Babe G, Perez R, Chan AKC, Chanchlani R (2020) Incidence, Risk Factors, and Outcomes of Neonatal Renal Vein Thrombosis in Ontario: Population-Based Cohort Study. Kidney 360:640–647. https://doi.org/10.34067/KID.0000912019

    Article  Google Scholar 

  5. Andrew M, Brooker LA (1996) Hemostatic complications in renal disorders of the young. Pediatr Nephrol 10:88–99. https://doi.org/10.1007/BF00863459

    Article  CAS  PubMed  Google Scholar 

  6. Andrew M, David M, Adams M, Ali K et al (1994) Venous thromboembolic complications (VTE) in children: first analyses of the Canadian Registry of VTE. Blood 83:1251–1257

    Article  CAS  PubMed  Google Scholar 

  7. Nowak-Göttl U, von Kries R, Göbel U (1997) Neonatal symptomatic thromboembolism in Germany: two year survey. Arch Dis Child Fetal Neonatal Ed 76:F163-167. https://doi.org/10.1136/fn.76.3.f163

    Article  PubMed  PubMed Central  Google Scholar 

  8. Schmidt B, Andrew M (1995) Neonatal thrombosis: report of a prospective Canadian and international registry. Pediatrics 96:939–943

    Article  CAS  PubMed  Google Scholar 

  9. Bacciedoni V, Attie M, Donato H, Comité Nacional de Hematología, Oncología y MedicinaTransfusional (2016) Thrombosis in newborn infants. Arch Argent Pediatr 114:159–166. https://doi.org/10.5546/aap.2016.eng.159

    Article  PubMed  Google Scholar 

  10. Zigman A, Yazbeck S, Emil S, Nguyen L (2000) Renal vein thrombosis: A 10-year review. J Pediatr Surg 35:1540–1542. https://doi.org/10.1053/jpsu.2000.18302

    Article  CAS  PubMed  Google Scholar 

  11. Lau KK, Stoffman JM, Williams S, McCusker P et al (2007) Neonatal renal vein thrombosis: review of the English-language literature between 1992 and 2006. Pediatrics 120:e1278-1284. https://doi.org/10.1542/peds.2007-0510

    Article  PubMed  Google Scholar 

  12. Resontoc LPR, Yap H-K (2016) Renal vascular thrombosis in the newborn. Pediatr Nephrol 31:907–915. https://doi.org/10.1007/s00467-015-3160-0

    Article  PubMed  Google Scholar 

  13. Andrew ME, Monagle P, deVeber G, Chan AKC (2001) Thromboembolic Disease and Antithrombotic Therapy in Newborns. Hematology 2001:358–374. https://doi.org/10.1182/asheducation-2001.1.358

    Article  Google Scholar 

  14. Manco-Johnson MJ, Grabowski EF, Hellgreen M, Kemahli AS et al (2002) Laboratory testing for thrombophilia in pediatric patients. On behalf of the Subcommittee for Perinatal and Pediatric Thrombosis of the Scientific and Standardization Committee of the International Society of Thrombosis and Haemostasis (ISTH). Thromb Haemost 88:155–156

    Article  CAS  PubMed  Google Scholar 

  15. Dauger S, Michot C, Garnier A, Hurtaud-Roux MF (2009) Thrombose néonatale des veines rénales en 2008. Arch Pediatr 16:132–141. https://doi.org/10.1016/j.arcped.2008.11.014

    Article  CAS  PubMed  Google Scholar 

  16. Marks SD, Massicotte MP, Steele BT, Matsell DG et al (2005) Neonatal renal venous thrombosis: clinical outcomes and prevalence of prothrombotic disorders. J Pediatr 146:811–816. https://doi.org/10.1016/j.jpeds.2005.02.022

    Article  PubMed  Google Scholar 

  17. Monagle P, Chan AKC, Goldenberg NA, Ichord RN et al (2012) Antithrombotic Therapy in Neonates and Children. Chest 141:e737S-e801S. https://doi.org/10.1378/chest.11-2308

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Monagle P, Cuello CA, Augustine C, Bonduel M et al (2018) American Society of Hematology 2018 Guidelines for management of venous thromboembolism: treatment of pediatric venous thromboembolism. Blood Adv 2:3292–3316. https://doi.org/10.1182/bloodadvances.2018024786

    Article  PubMed  PubMed Central  Google Scholar 

  19. Monagle P, Newall F (2018) Management of thrombosis in children and neonates: practical use of anticoagulants in children. Hematology Am Soc Hematol Educ Program 2018:399–404

    Article  PubMed  PubMed Central  Google Scholar 

  20. Manco-Johnson M, Grabowski E, Hellgreen M, Kemahli S et al (2002) Recommendations for tPA Thrombolysis in Children: On behalf of the Scientific Subcommittee on Perinatal and Pediatric Thrombosis of the Scientific and Standardization Committee of the International Society of Thrombosis and Haemostasis. Thromb Haemost 88:157–158. https://doi.org/10.1055/s-0037-1613170

    Article  CAS  PubMed  Google Scholar 

  21. Garcelon N, Neuraz A, Salomon R, Faour H et al (2018) A clinician friendly data warehouse oriented toward narrative reports: Dr. Warehouse J Biomed Inform 80:52–63. https://doi.org/10.1016/j.jbi.2018.02.019

    Article  PubMed  Google Scholar 

  22. Elsaify WM (2009) Neonatal renal vein thrombosis: grey-scale and Doppler ultrasonic features. Abdom Imaging 34:413–418. https://doi.org/10.1007/s00261-008-9394-6

    Article  PubMed  Google Scholar 

  23. Ablin AR, Kushner JH, Murphy A, Zippin C (1961) Platelet enumeration in the neonatal period. Pediatrics 28:822–824

    Article  CAS  PubMed  Google Scholar 

  24. Starr MC, Flynn JT (2019) Neonatal Hypertension: Cases, Causes and Clinical Approach. Pediatr Nephrol 34:787–799. https://doi.org/10.1007/s00467-018-3977-4

    Article  PubMed  Google Scholar 

  25. Zappitelli M, Ambalavanan N, Askenazi DJ, Moxey-Mims MM et al (2017) Developing a neonatal acute kidney injury research definition: a report from the NIDDK neonatal AKI workshop. Pediatr Res 82:569–573. https://doi.org/10.1038/pr.2017.136

    Article  PubMed  PubMed Central  Google Scholar 

  26. Erdemir A, Kahramaner Z, Cicek E, Turkoglu E et al (2013) Reference ranges for sonographic renal dimensions in preterm infants. Pediatr Radiol 43:1475–1484. https://doi.org/10.1007/s00247-013-2728-8

    Article  PubMed  Google Scholar 

  27. Inker LA, Astor BC, Fox CH, Isakova T et al (2014) KDOQI US Commentary on the 2012 KDIGO Clinical Practice Guideline for the Evaluation and Management of CKD. Am J Kidney Dis 63:713–735. https://doi.org/10.1053/j.ajkd.2014.01.416

    Article  Google Scholar 

  28. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, STROBE Initiative (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med 147:573–577

    Article  Google Scholar 

  29. Kosch A, Kuwertz-Bröking E, Heller C, Kurnik K et al (2004) Renal venous thrombosis in neonates: prothrombotic risk factors and long-term follow-up. Blood 104:1356–1360. https://doi.org/10.1182/blood-2004-01-0229

    Article  CAS  PubMed  Google Scholar 

  30. Bökenkamp A, Von Kries R, Nowak-Göttl U, Göbel U et al (2000) Neonatal renal venous thrombosis in Germany between 1992 and 1994: epidemiology, treatment and outcome. Eur J Pediatr 159:44–48. https://doi.org/10.1007/s004310050008

    Article  PubMed  Google Scholar 

  31. Toti MS, Ghirri P, Bartoli A, Caputo C et al (2019) Adrenal hemorrhage in newborn: how, when and why- from case report to literature review. Ital J Pediatr 45:58. https://doi.org/10.1186/s13052-019-0651-9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Winyard PJD, Bharucha T, De Bruyn R, Dillon MJ et al (2006) Perinatal renal venous thrombosis: presenting renal length predicts outcome. Arch Dis Child Fetal Neonatal Ed 91:F273–F278. https://doi.org/10.1136/adc.2005.083717

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Goldenberg NA, Abshire T, Blatchford PJ, Fenton LZ et al (2015) Multicenter randomized controlled trial on Duration of Therapy for Thrombosis in Children and Young Adults (the Kids-DOTT trial): pilot/feasibility phase findings. J Thromb Haemost 13:1597–1605. https://doi.org/10.1111/jth.13038

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Pernod G, Biron-Andreani C, Gal GL, Trillot N et al (2012) Prescription d’un bilan de thrombophilie. Société Française de Médecine Vasculaire 2

Download references

Funding

Not applicable.

Author information

Authors and Affiliations

  1. Department of Pediatric Nephrology, Robert Debré University Hospital, Assistance Publique – Hôpitaux de Paris, and University of Paris, Paris, France

    Bellaure Ndoudi Likoho, Claire Dossier, Véronique Baudouin, Julien Hogan, Theresa Kwon & Anne Couderc

  2. Department of Pediatric Nephrology, Necker-Enfants-Malades University Hospital, Assistance Publique – Hôpitaux de Paris, and University of Paris, Paris, France

    Romain Berthaud & Olivia Boyer

  3. Department of Pediatric Nephrology, Trousseau University Hospital, Assistance Publique – Hôpitaux de Paris, and Sorbonne University, Paris, France

    Jean-Daniel Delbet

  4. Department of Pediatric Radiology, Robert Debré University Hospital, Assistance Publique – Hôpitaux de Paris, and University of Paris, Paris, France

    Marianne Alison

  5. Neonatal Intensive Care Unit, Robert Debré University Hospital, Assistance Publique – Hôpitaux de Paris, and University of Paris, Paris, France

    Valérie Biran

  6. Biological Hematology Department, Robert Debré University Hospital, Assistance Publique – Hôpitaux de Paris, and University of Paris, Paris, France

    Marie-Françoise Hurtaud

Authors
  1. Bellaure Ndoudi Likoho
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Romain Berthaud
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Claire Dossier
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jean-Daniel Delbet
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Olivia Boyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Véronique Baudouin
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marianne Alison
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Valérie Biran
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Marie-Françoise Hurtaud
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Julien Hogan
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Theresa Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Anne Couderc
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bellaure Ndoudi Likoho.

Ethics declarations

Ethics approval

No. 2021-539bis of the Robert Debré University Hospital’s Ethics Review Committee for Research Projects.

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ndoudi Likoho, B., Berthaud, R., Dossier, C. et al. Renal vein thrombosis in neonates: a case series of diagnosis, treatment and childhood kidney function follow-up. Pediatr Nephrol 38, 3055–3063 (2023). https://doi.org/10.1007/s00467-023-05918-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-023-05918-w

Keywords

Search

Navigation