title: Factors affecting spontaneous resolution of hematuria in childhood nutcracker syndrome.
abstract: To identify factors affecting spontaneous resolution of hematuria in children with nutcracker syndrome, 20 patients diagnosed as having nutcracker syndrome using renal Doppler ultrasound (US) were analyzed retrospectively. Sixteen patients had microscopic hematuria, and four had gross hematuria at presentation. The mean age was 10.6 years (range 2.5-14 years). All underwent a follow-up Doppler US examination after a mean period of 1.4 years (range 0.5-3.5 years) after the first US was performed, and height and weight were measured at the time of US. At the time of follow-up US, hematuria disappeared in 15 patients and improved in 3. The peak velocity (PV) ratios of the left renal vein (LRV) at the follow-up US decreased significantly when compared to the first US examination (7.74+/-2.64 vs 3.50+/-1.09, p<0.0001), and height (147.4+/-20.1 vs 152.3+/-18.8 cm) and weight (36.1+/-10.9 vs 42.3+/-12.7 kg) increased (p<0.0001). Changes in the PV ratios of the LRV correlated positively with changes in the PV at the aortomesenteric portion (r=0.569, p=0.009). Changes in the PV at the aortomesenteric portion correlated negatively with changes in body mass index (BMI) (r=-0.543, p=0.013). Although spontaneous resolution of hematuria in children with nutcracker syndrome is obscure, our findings suggest the increase in BMI may be a possible hemodynamic factor.
authors.affiliation: Department of Pediatrics, The Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jae Il
authors.initials: JI
authors.lastname: Shin
authors.forename: Jee Min
authors.initials: JM
authors.lastname: Park
authors.forename: Soon Min
authors.initials: SM
authors.lastname: Lee
authors.forename: Youn Ho
authors.initials: YH
authors.lastname: Shin
authors.forename: Ji Hong
authors.initials: JH
authors.lastname: Kim
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Lee
authors.forename: Myung Joon
authors.initials: MJ
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D001011:Aorta; D001783:Blood Flow Velocity; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006417:Hematuria / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012075:Remission, Spontaneous; D012082:Renal Veins / Q000000981:diagnostic imaging / Q000502:physiology*; D012189:Retrospective Studies; D018608:Ultrasonography, Doppler