Renal vein thrombosis in idiopathic membranous glomerulopathy and nephrotic syndrome: Incidence and significance

Renal vein thrombosis in idiopathic membranous glomerulopathy and nephrotic syndrome: Incidence and significance. The point prevalence and clinical significance of renal vein thrombosis (RVT) was evaluated in 27 of 33 consecutive nephrotic patients with idiopathic membranous glomerulopathy. A technique of retrograde venography after the injection of epinephrine into the main renal artery to decrease renal blood flow was used. Two patients had histories compatible with a thromboembolic event, and the excretory urogram was not suggestive of RVT in any patient. RVT was noted in 13 patients; in eight it was bilateral. All patients with RVT received anticoagulant drugs for a minimum of 1 year after the study, and no thromboembolic events occurred in this group. No patient was treated with corticosteroids. Follow-up observation of an average of 2.5 years has not revealed a significant difference in the rate of renal function deterioration or change in degree of proteinuria between patients with and without RVT. Coagulation abnormalities included elevated platelet counts and plasma fibrinogen levels and prolonged reptilase and thrombin times. These were noted in all 14 patients studied, six of whom had RVT. In patients experiencing a nephrotic remission, coagulation abnormalities reverted to normal. RVT is common in idiopathic membranous glomerulopathy with nephrosis and is associated with few clinical markers. Its influence on renal function and proteinuria is of questionable significance. Coagulation abnormalities may be a causative factor of RVT in this setting. Thrombose des veines rénales dans la glomérulonéphrite extramembraneuse idiopathique et le syndrome néphrotique: Incidence et signification. La prévalence et la signification clinique de la thrombose des veines rénales (RVT) ont été évaluées chez 27 sur 33 malades consécutifs néphrotiques avec une glomérulonéphrite extramembraneuse idiopathique. Une technique de phlébographie rétrograde après injection d'adrénaline dans l'artère rénale principale afin de diminuer le flux sanguin rénal a été utilisée. Deux malades avaient des histoires compatibles avec un accident thrombo-embolique, mais l'urographie n'était évocatrice de RVT chez aucun malade. Une RVT a été notée chez 13 malades; chez huit elle était bilatérale. Tous les malades ayant une RVT ont reçu des anticoagulants pendant au moins 1 an après l'étude, et aucun accident thrombo-embolique n'est survenu dans ce groupe. Aucun malade n'a été traité ave