Clinical characteristics and long-term follow-up of patients with renal vein thrombosis.
BACKGROUND
To determine whether treatment guidelines for patients with lower-extremity venous thrombosis (DVT) could be applied to patients with renal vein thrombosis (RVT). The rates of recurrent venous thrombosis and survival for patients with these 2 diseases were compared.


METHODS
Inception cohort of individuals was identified with their first lifetime incident of RVT. Recurrent thrombosis and survival were compared with those for patients with DVT in a case-control fashion.


METHODS
All patients with a diagnosis of RVT at Mayo Clinic from 1980 to 2000.


METHODS
Survival and recurrent venous thrombosis rates were compared with those for patients with DVT. Survival rates were also compared with those for US white residents.


RESULTS
218 patients (mean age, 55 +/- 19 years) were included (35% women). Malignancy (66%) and nephrotic syndrome (20%) were the most common underlying causes. Warfarin was prescribed for 74 patients (46% with lifelong therapy). During a mean follow-up of 42 +/- 57 months (768 patient-years), there were 8 recurrent venous thrombotic events (1.0/100 patient-years). This recurrence rate was less than that for patients with DVT (P < 0.001). Survival was lower compared with patients with DVT or age- and sex-matched US white residents (P < 0.001). Active malignancy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.2 to 4.7) and infection (HR, 2.4; 95% CI, 1.4 to 4.0) were associated with poor survival. Survival was influenced positively by warfarin therapy (HR, 0.53; 95% CI, 0.31 to 0.90).


CONCLUSIONS
Retrospective nonrandomized study.


CONCLUSIONS
RVT represents a distinct clinical entity with unique recurrence and survival rates. The finding of RVT should prompt a thorough evaluation for an underlying renal malignancy. Oral anticoagulation therapy may be associated with a survival advantage.
Wysokinski
Waldemar E
WE
Division of Cardiovascular Medicine, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
Gosk-Bierska
Izabela
I
Greene
Eddie L
EL
Grill
Diane
D
Wiste
Heather
H
McBane
Robert D
RD
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009404:Nephrotic Syndrome / Q000150:complications; D016017:Odds Ratio; D012008:Recurrence; D012082:Renal Veins; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality*; D020246:Venous Thrombosis / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality*; D014859:Warfarin / Q000627:therapeutic use*; D044465:White People / Q000706:statistics & numerical data
D000925:Anticoagulants; D014859:Warfarin