Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (549 page)

   This condition is characterized by the formation of a thrombus that obstructs one or both renal veins.

   Most commonly associated with nephrotic syndrome and severe dehydration. Other causes include trauma, DIC, tumors, oral contraceptives, and hypovolemia (especially in infants).

   Who Should Be Suspected?

   Infants with acute loss of renal function.

   Patients with subacute or chronic deterioration of renal function in the appropriate setting, including those with thrombophilia or an underlying renal disease.

   Frequently associated with deep vein thrombosis or pulmonary embolism.

   Acute onset is associated with pain in the lower back and sides of the abdomen, fever, decreased urine output, and bloody urine.

   Laboratory Findings

   Diagnosis is made by imaging studies.

   Urinalysis shows mild proteinuria and RBCs.

   Fibrin degradation products and
D
-dimer can be elevated.

   Various findings according to the underlying disease.

Suggested Reading

Wysokinski WE, Gosk-Bierska I, Green EL, et al. Clinical characteristics and long-term follow-up of patients with renal vein thrombosis.
Am J Kidney Dis.
2008;51:224–232.

URIC ACID NEPHROPATHY

   Definition