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Hemodynamics in nutcracker syndrome: implications for diagnosis

  • Original Article
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Journal of Nephrology Aims and scope Submit manuscript

Abstract

Background

Nutcracker syndrome is a disease characterized by complex symptoms, making its diagnosis challenging and often delayed, often resulting in a painful experience for the patients.

Objective

This study aimed to investigate the pathogenesis of nutcracker syndrome through the perspective of hemodynamics by simulating blood flow with varying compression degrees of the left renal vein.

Methods

3D patient-specific vascular models of the abdominal aorta, superior mesenteric artery and left renal vein were constructed based on CT images of patients suspected of having nutcracker syndrome. A hemodynamic simulation was then conducted using computational fluid dynamics to identify the correlation between alterations in hemodynamic parameters and varying degrees of compression.

Results

The study indicated the presence of an evident gradient in velocity distribution over the left renal vein with relatively high degrees of stenosis (α ≤ 50°), with maximum velocity in the central region of the stenosis. Additionally, when the compression degree of the left renal vein increases, the pressure distribution of the left renal vein presents an increasing number of gradient layers. Furthermore, the wall shear stress shows a correlation with the variation of blood flow velocity, i.e., the increase of wall shear stress correlates with the acceleration of the blood flow velocity.

Conclusions

Using computational fluid dynamics as a non-invasive instrument to obtain the hemodynamic characteristics of nutcracker syndrome is feasible and could provide insights into the pathological mechanisms of the nutcracker syndrome supporting clinicians in diagnosis. 

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

This research was supported by the Fundamental Research Funds for Science and Technology in Xuzhou [KC20191].

Author information

Authors and Affiliations

  1. Xuzhou Medical University, 209 Tongshan Road, Xuzhou, 221004, China

    Hui Tang, Qun Chen, Yuexing Zhu, Lu Tang, Yinghong Zhao & Jinqiu Hu

  2. China University of Mining and Technology, No.1, Daxue Road, Xuzhou, 221116, China

    Yinghong Zhao & Gang Hua

  3. School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 611731, China

    Xianchao Yu

  4. The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221004, China

    Shikun Zhang

Authors
  1. Hui Tang
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  2. Xianchao Yu
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  4. Yuexing Zhu
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  5. Shikun Zhang
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  6. Lu Tang
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  7. Yinghong Zhao
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  8. Gang Hua
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  9. Jinqiu Hu
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Contributions

HT and YHZ: experiment design and manuscript drafting. XCY and QC: modeling, simulation, data analysis and curation, visualization, project administration. YXZ and SKZ: modeling, data curation, visualization. LT and JP: conceptualization, methodology, writing and editing. GH and JQH: resources, writing and editing. All authors gave final approval for publication and agree to be held accountable for the work performed therein.

Corresponding authors

Correspondence to Yinghong Zhao or Gang Hua.

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Conflict of interest

The author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethics approval and consent to participate

This study was approved by the Affiliated Hospital of Xuzhou Medical University Ethics Review Committee and conducted according to the principles of the Declaration of Helsinki.

Human and animal rights

All procedures were approved by the Xuzhou Medical University Institutional Review Board.

Informed consent

Informed consent was obtained from all the participants included in the study.

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Tang, H., Yu, X., Chen, Q. et al. Hemodynamics in nutcracker syndrome: implications for diagnosis. J Nephrol (2024). https://doi.org/10.1007/s40620-024-01894-y

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