Neonatal renal venous thrombosis: clinical outcomes and prevalence of prothrombotic disorders.
OBJECTIVE
To determine clinical outcomes and the prevalence of prothrombotic conditions in patients who had neonatal renal venous thrombosis (RVT).


METHODS
A retrospective cohort of neonates with RVT who were admitted to 4 pediatric centers from 1980 to 2001 was identified. Information on clinical presentation, laboratory and radiological investigation, and treatment were abstracted. Survivors were evaluated for renal status and prothrombotic conditions.


RESULTS
Forty-three patients with neonatal RVT were identified. RVT was unilateral in 24 patients (56%) and associated with 2thrombi at other sites in 32 patienets (74%). Clinical presentations included renal failure in 24 patients (56%), thrombocytopenia, anemia, or both in 22 patients (51%), and renal mass in 21 patients (49%). Neonatal interventions included anti-coagulants in 28 patients (65%), antihypertensive medications in 9 patients (21%), peritoneal dialysis in 2 patients (5%), and nephrectomy in 2 patients (5%). The median age at follow-up was 3.7 years (range, 0.5-20.2 years). Thirteen patients (34%) had hypertension, and 11 patients (29%) had renal failure. End-stage renal disease developed in 3 patients, and they underwent live-related renal transplants. Twelve of the 28 patients (43%) examined had prothrombotic abnormalities.


CONCLUSIONS
Neonatal RVT is associated with significant renal morbidity and a high prevalence of prothrombotic abnormalities.
Marks
Stephen D
SD
Division of Nephrology, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Ontario, Canada.
Massicotte
M Patricia
MP
Steele
Brian T
BT
Matsell
Douglas G
DG
Filler
Guido
G
Shah
Prakesh S
PS
Perlman
Max
M
Rosenblum
Norman D
ND
Shah
Vibhuti S
VS
D000293:Adolescent; D000328:Adult; D000751:Anemia, Neonatal / Q000209:etiology; D000925:Anticoagulants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001284:Atrophy; D025861:Blood Coagulation Disorders, Inherited / Q000453:epidemiology*; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation; D008297:Male; D009392:Nephrectomy; D010530:Peritoneal Dialysis; D015995:Prevalence; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000209:etiology / Q000601:surgery; D012082:Renal Veins; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000209:etiology; D020246:Venous Thrombosis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy
D000925:Anticoagulants; D000959:Antihypertensive Agents