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Neonatal renal venous thrombosis: clinical outcomes and prevalence of prothrombotic disorders.

https://arctichealth.org/en/permalink/ahliterature174210
Source
J Pediatr. 2005 Jun;146(6):811-6
Publication Type
Article
Date
Jun-2005
Author
Stephen D Marks
M Patricia Massicotte
Brian T Steele
Douglas G Matsell
Guido Filler
Prakesh S Shah
Max Perlman
Norman D Rosenblum
Vibhuti S Shah
Author Affiliation
Division of Nephrology, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Ontario, Canada.
Source
J Pediatr. 2005 Jun;146(6):811-6
Date
Jun-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anemia, Neonatal - etiology
Anticoagulants - therapeutic use
Antihypertensive Agents - therapeutic use
Atrophy
Blood Coagulation Disorders, Inherited - epidemiology
Canada - epidemiology
Child
Child, Preschool
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Kidney - pathology
Kidney Transplantation
Male
Nephrectomy
Peritoneal dialysis
Prevalence
Prospective Studies
Renal Insufficiency - etiology - surgery
Renal Veins
Retrospective Studies
Thrombocytopenia - etiology
Venous Thrombosis - diagnosis - epidemiology - therapy
Abstract
To determine clinical outcomes and the prevalence of prothrombotic conditions in patients who had neonatal renal venous thrombosis (RVT).
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.
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.
Neonatal RVT is associated with significant renal morbidity and a high prevalence of prothrombotic abnormalities.
PubMed ID
15973324 View in PubMed
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Neonatal thrombosis: report of a prospective Canadian and international registry.

https://arctichealth.org/en/permalink/ahliterature214049
Source
Pediatrics. 1995 Nov;96(5 Pt 1):939-43
Publication Type
Article
Date
Nov-1995
Author
B. Schmidt
M. Andrew
Author Affiliation
Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Source
Pediatrics. 1995 Nov;96(5 Pt 1):939-43
Date
Nov-1995
Language
English
Publication Type
Article
Keywords
Canada
Female
Gestational Age
Humans
Infant, Newborn
Infant, Newborn, Diseases - diagnosis - epidemiology - therapy
Male
Outcome Assessment (Health Care)
Prognosis
Prospective Studies
Questionnaires
Registries
Renal Veins
Risk factors
Thrombosis - diagnosis - epidemiology - therapy
Abstract
We sought to obtain representative data on the risk factors, diagnosis, current management, and short-term outcome of neonatal thrombosis.
A case registry was established at McMaster University. Standardized questionnaires were mailed to collaborators at participating centers every 4 to 6 months.
Eighty-five level III and modified level II neonatal units in North America, Europe, and Australia were invited to join the registry.
Eligible infants were born between January 1990 and June 1993. Large-vessel thrombosis was diagnosed during the first month of life or up to 44 weeks post-conception after premature birth. The clinical impression of thrombotic vessel obstruction was confirmed using at least one imaging technique.
Physicians in 64 centers expressed their willingness to participate. A total of 97 cases (excluding stroke) were registered from 29 centers. Spontaneous renal venous thrombosis (n = 21) was diagnosed at a median age of 2 days. The other venous (n = 39), arterial (n = 33), and mixed (n = 4) thromboses presented later; 89% of them were associated with an intravascular catheter and 29% with systemic infection. Doppler ultrasonography was the definitive diagnostic test in 68% of cases; contrast angiography was performed infrequently (14%). A third of all patients (but 62% of infants with renal venous thrombosis) received supportive therapy only. Thrombolytic agents were prescribed for 28% of catheter-associated venous thromboses and 30% of all arterial thromboses. The remainder of the patients were given heparin. Most patients (82%) survived to hospital discharge. Mortality rates were highest among infants with aortic thrombosis or central venous line-associated thrombosis affecting the right atrium or the superior vena cava (33%).
Neonatal thrombosis is diagnosed fairly rarely. With the exception of spontaneous renal venous thrombosis, almost all cases are associated with indwelling catheters. Doppler ultrasound techniques are the most popular means of confirming the diagnosis in virtually all centers. Treatment varies greatly among different centers, probably because of the lack of scientific evidence about the optimum management of affected infants.
PubMed ID
7478839 View in PubMed
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Predictors of early mortality after radical nephrectomy with renal vein or inferior vena cava thrombectomy - a population-based study.

https://arctichealth.org/en/permalink/ahliterature125248
Source
BJU Int. 2012 Nov;110(9):1283-8
Publication Type
Article
Date
Nov-2012
Author
Stanley A Yap
David Horovitz
Shabbir M H Alibhai
Robert Abouassaly
Narhari Timilshina
Antonio Finelli
Author Affiliation
Division of Urologic Oncology, Princess Margaret Hospital and Department of Health Policy, University of Toronto, Toronto, Ontario, Canada.
Source
BJU Int. 2012 Nov;110(9):1283-8
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Female
Health Facility Size - statistics & numerical data
Humans
Kidney Neoplasms - mortality - surgery
Male
Middle Aged
Mortality, Premature
Multivariate Analysis
Nephrectomy - methods - mortality - statistics & numerical data
Ontario - epidemiology
Renal Veins - surgery
Retrospective Studies
Thrombectomy - methods - mortality - statistics & numerical data
Urology - statistics & numerical data
Vena Cava, Inferior - surgery
Venous Thrombosis - surgery
Workload - statistics & numerical data
Abstract
Study Type - Prognosis (cohort) Level of Evidence 2a. What's known on the subject? and What does the study add? Surgical volume has been well established as a predictor of outcomes for several complex surgical procedures, yet few studies have evaluated this relationship with regards to radical nephrectomy with either renal vein or inferior vena cava thrombectomy. In addition, most published literature consists of single-institution series from centres of excellence. We performed a population-level analysis and identified surgeon volume as a significant predictor of short-term mortality for this procedure. Such findings have potential implications regarding future policy and regionalization of care.
â?¢ To study the short-term mortality associated with radical nephrectomy with renal vein or inferior vena cava thrombectomy and the variables associated with this adverse outcome.
â?¢ Using the Ontario Cancer Registry, we identified 433 patients in the province of Ontario, Canada undergoing radical nephrectomy with venous thrombectomy between 1995 and 2004. â?¢ We determined mortality rates at postoperative days 30 and 90. â?¢ Other variables analysed include pathological tumour characteristics, surgeon graduation year, hospital/surgeon academic status, surgery year and hospital/surgeon volume. â?¢ We used multivariable logistic regression to assess outcomes.
â?¢ Overall mortality was 2.8% (30-day) and 5.8% (90-day). â?¢ Surgeons performing a single nephrectomy with venous thrombectomy performed 14% of the cases and had the highest 30-day (6.7%) and 90-day (10%) mortality. The mortality rate for surgeons performing more than one surgery was 2.1% (30-day) and 5.1% (90-day). â?¢ In recent years, this procedure was performed more commonly by the highest volume surgeons - 67% of cases in 2004 vs 40% in 1995. â?¢ Significant predictors of 30-day mortality included procedure year and low surgeon volume. â?¢ Significant predictors of 90-day mortality included procedure year, low surgeon volume, left-sided tumour and increasing hospital volume.
â?¢ For radical nephrectomy with venous thrombectomy, surgeon volume predicts short-term mortality, emphasizing the importance of experience in patient outcome. â?¢ Despite a shift towards high-volume surgeons, 13.8% of cases continued to be performed by low-volume providers. â?¢ If these results are confirmed in other jurisdictions, radical nephrectomy with venous thrombectomy should be regionalized and performed by surgeons who manage these cases regularly.
PubMed ID
22500493 View in PubMed
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A prospective randomized trial of the selective distal splenorenal shunt.

https://arctichealth.org/en/permalink/ahliterature246400
Source
Surg Gynecol Obstet. 1980 Jan;150(1):45-8
Publication Type
Article
Date
Jan-1980
Author
B. Langer
L E Rotstein
R M Stone
B R Taylor
S C Patel
L M Blendis
R F Colapinto
Source
Surg Gynecol Obstet. 1980 Jan;150(1):45-8
Date
Jan-1980
Language
English
Publication Type
Article
Keywords
Adult
Aged
Esophageal and Gastric Varices - complications - therapy
Female
Gastrointestinal Hemorrhage - etiology
Humans
Liver Cirrhosis - surgery
Male
Middle Aged
Ontario
Portacaval Shunt, Surgical
Postoperative Complications - mortality
Prospective Studies
Random Allocation
Renal Veins - surgery
Splenic Vein - surgery
Abstract
Distal splenorenal shunt has been compared in a prospective randomized way with end-to-side portacaval shunt in patients who have survived a major hemorrhage from esophageal varices. The operative mortality was higher after the elective shunt than after the portacaval shunt. However, most of these deaths occurred in the early phases of the study. Postoperative encephalopathy was significantly lower after the selective shunt than after the portacaval shunt. Follow-up studies to date show no significant difference in late survival.
PubMed ID
6965330 View in PubMed
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The protean manifestations of renal vein thrombosis in the adult.

https://arctichealth.org/en/permalink/ahliterature251020
Source
J Urol. 1976 Jun;115(6):634-8
Publication Type
Article
Date
Jun-1976
Author
H G Kiruluta
A W Bruce
S V Jarzylo
P A Morrin
Source
J Urol. 1976 Jun;115(6):634-8
Date
Jun-1976
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - complications
Adult
Anticoagulants - therapeutic use
Autopsy
Humans
Kidney Neoplasms - complications
Male
Ontario
Phlebography
Renal Veins - pathology
Thrombosis - diagnosis - epidemiology - pathology
Abstract
We reviewed 8 cases of renal vein thrombosis, 4 of which were detected at autopsy, 1 by laparotomy and the remaining 3 by venography. In 4 cases malignancy also was found and in 2 membranous glomerulonephritis was noted. In 1 patient the thrombosis occurred in a solitary kidney, while it was bilateral in 3. The 4 patients in whom the diagnosis was made during life were treated with anticoagulants alone and 3 are alive with stable renal function 3, 4 and 7 1/2 years after diagnosis.
PubMed ID
940192 View in PubMed
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Renal vein thrombosis: a 10-year review.

https://arctichealth.org/en/permalink/ahliterature196624
Source
J Pediatr Surg. 2000 Nov;35(11):1540-2
Publication Type
Article
Date
Nov-2000
Author
A. Zigman
S. Yazbeck
S. Emil
L. Nguyen
Author Affiliation
Département de Chirurgie, Hjpital Sainte-Justine, and the Montreal Children's Hospital, Montreal, Quebec, Canada.
Source
J Pediatr Surg. 2000 Nov;35(11):1540-2
Date
Nov-2000
Language
English
Publication Type
Article
Keywords
Adolescent
Age Distribution
Anticoagulants - administration & dosage
Female
Follow-Up Studies
Humans
Incidence
Infant, Newborn
Male
Quebec - epidemiology
Renal Veins
Retrospective Studies
Risk factors
Sex Distribution
Survival Rate
Venous Thrombosis - diagnosis - drug therapy - epidemiology
Abstract
Renal vein thrombosis (RVT) is a rare cause for pediatric surgical consultation. The purpose of this study is to review the Montreal experience in the 1990s with RVT.
A retrospective chart review was conducted from 1990 through 1999.
Twenty-three cases were identified by Duplex ultrasound scan. Mean length of follow-up was 42 months. Eighty-three percent (83%) of cases were diagnosed within the first month of life. In utero thrombosis was suspected in 22% and was associated with caval thrombosis and factor V Leiden. Known risk factors were present in 87%. The "diagnostic triad" of flank mass, gross hematuria, and thrombocytopenia was present in only 13% at the time of diagnosis. Long-term renal function impairment was detected in 100% of those who did not receive heparin, and in 33% of those who did receive heparin. No patient required dialysis. One patient required nephrectomy for recurrent pyelonephritis.
RVT occurs more commonly than anticipated. Because the "classic" triad of signs usually is absent at presentation, the presence of either a flank mass, hematuria, or thrombocytopenia in a patient with risk factors should prompt investigation for RVT. Factor V Leiden is a risk factor for in utero RVT. Anticoagulation improves renal outcome. Patients with RVT require long-term follow-up.
PubMed ID
11083418 View in PubMed
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[Results of splenorenal venous bypass grafting in patients with hepatocirrhosis].

https://arctichealth.org/en/permalink/ahliterature108642
Source
Angiol Sosud Khir. 2013;19(2):112-6
Publication Type
Article
Date
2013
Author
I I Katel'nitskii
N G Sapronova
Source
Angiol Sosud Khir. 2013;19(2):112-6
Date
2013
Language
Russian
Publication Type
Article
Keywords
Adolescent
Adult
Anastomosis, Surgical - adverse effects - methods
Child
Female
Follow-Up Studies
Humans
Hypertension, Portal - etiology - physiopathology - surgery
Incidence
Liver Cirrhosis - complications - surgery
Male
Middle Aged
Postoperative Hemorrhage - epidemiology - etiology
Renal Veins - surgery
Retrospective Studies
Russia - epidemiology
Splenic Vein - surgery
Time Factors
Treatment Outcome
Vascular Surgical Procedures - adverse effects - methods
Young Adult
Abstract
Presented herein are the results of surgical treatment of 79 patients with intrahepatic portal hypertension who underwent splenorenal venous bypass grafting after splenectomy. The patients' age varied from 8 to 64 years, averaging 37.3 years. The authors followed up the immediate and remote results of treatment at terms varying from 1 to 20 years. Of the early postoperative complications mention should be made that intra-abdominal haemorrhage was revealed in 4 (5%) patients, six (7.6%) patients were found to develop left-side reactive pleuritis, one patient (1.2%) - bilateral pleuritis and pericarditis, subcutaneous eventration was revealed in 1 patient with pronounced ascites (1.2%). Haemorrhage from varicose dilated oesophageal veins in the early postoperative period was observed in 8 (10%) cases. Posthaemorrhagic anaemia was present in 27 cases (43.1%). The mortality rate in the early postoperative period amounted to 5% (4). We followed up the long-term results in 51 (64.5%) of the 79 patients at terms up to 5 years after surgery, in 17 patients at terms up to 10 years following interventions, in 9 at terms up to 15 years, and in one patient up to 20 years. A total of 3 patients died within the first postoperative year. 48 (94%) patients are alive 5 years after the operation, 10 - after ten years, with 7 having died. Five patients are still alive more than 15 years, four died, one followed up woman is still alive after 20 years with a satisfactory result.
PubMed ID
23863796 View in PubMed
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Symptomatic thrombotic events among Egyptian patients with systemic lupus erythematosus: special consideration for renal vein thrombosis.

https://arctichealth.org/en/permalink/ahliterature71313
Source
Z Rheumatol. 2003 Jun;62(3):246-50
Publication Type
Article
Date
Jun-2003
Author
A A Shahin
H. Mostafa
H. Sami
H A Shahin
Author Affiliation
Department of Rheumatology and Rehabilitation, 453 Al-Ahram Street, Al-Ahram, Giza, Egypt. rughe@rusys.eg.net
Source
Z Rheumatol. 2003 Jun;62(3):246-50
Date
Jun-2003
Language
English
Publication Type
Article
Keywords
Adult
Antibodies, Anticardiolipin - blood
Biopsy
Diagnostic Imaging
Egypt
Female
Humans
Kidney - pathology
Lupus Erythematosus, Systemic - diagnosis - pathology
Lupus Nephritis - diagnosis - pathology
Male
Nephrotic Syndrome - diagnosis - pathology
Renal Veins - pathology
Risk factors
Thrombosis - diagnosis - pathology
Vena Cava, Inferior - pathology
Abstract
OBJECTIVE: To evaluate the prevalence of symptomatic thrombotic events among Egyptian patients with systemic lupus erythematosus (SLE), and to evaluate the frequency and the risk factors associated with renal vein thrombosis in those patients. METHODS: Fifty-four patients with SLE, 51 (94.4%) females, were involved in this study. All of them were submitted for abdominal sonography, chest X-ray, echocardiography, and Doppler of renal, abdominal and lower limb veins, with examination of data on clinical and laboratory profile. Abdominal CT, brain MRI, MRI both hips, CT chest and pulmonary scintigraphy were used when needed. RESULTS: Sixteen patients (29.6%) were diagnosed with symptomatic thrombotic events. Eight patients had more than one type of thrombosis. Two patients (3.7%) were diagnosed by Doppler as having renal vein thrombosis (RVT). This was confirmed by abdominal CT. One of them presented with nephrotic syndrome, graded by renal biopsy as World Health Organization (WHO) class V, and had positive anticardiolipin antibodies (ACL). The other patient had RVT and inferior vena cava (IVC) thrombosis, nephrotic syndrome, positive ACL, and died before renal biopsy was performed. Both of them were without history of peripheral thrombotic events. One patient was diagnosed with IVC thrombosis, lupus nephritis grade II, positive ACL, and diagnosed by abdominal CT. One patient was diagnosed with portal vein thrombosis and had positive ACL. One patient with retinal vessel thrombosis and positive ACL. Four patients had deep vein thrombosis (DVT). Recurrent miscarriages were reported in 4 patients (7.4%), skin ulcerations in 3 (5.6%), avascular necrosis of the hips in 4 (7.4%), stroke in 1 (1.9%), and pulmonary hypertension in 2 patients (3.7%). CONCLUSION: Sixteen SLE patients (29.6%) were diagnosed with symptomatic thrombotic events. RVT was detected in 2 patients representing 3.7% of all patients, and 12.5% of patients with thrombosis. Both patients with RVT presented with nephrotic syndrome.
PubMed ID
12827401 View in PubMed
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Venous blood flow in maternal kidneys in third trimester of pregnancy.

https://arctichealth.org/en/permalink/ahliterature309704
Source
J Matern Fetal Neonatal Med. 2020 Jul; 33(13):2246-2252
Publication Type
Journal Article
Date
Jul-2020
Author
Torbjørn Moe Eggebø
Eva Johanne Leknes Jensen
Karin Ulrike Deibele
Thomas Scholbach
Author Affiliation
National Center for Fetal Medicine, Trondheim University Hospital, St Olav's Hospital, Trondheim, Norway.
Source
J Matern Fetal Neonatal Med. 2020 Jul; 33(13):2246-2252
Date
Jul-2020
Language
English
Publication Type
Journal Article
Keywords
Adult
Blood Flow Velocity
Female
Humans
Kidney - blood supply - diagnostic imaging
Pregnancy
Pregnancy Trimester, Third
Prospective Studies
Renal Artery - diagnostic imaging - physiology
Renal Veins - diagnostic imaging - physiology
Ultrasonography, Doppler - methods
Abstract
Objectives: Maternal intra-abdominal pressure and hemodynamics change during pregnancy. The left renal vein may be compressed between the uterus and the spine and aorta, causing congestion and impaired venous return from the left kidney during late pregnancy. The aim of this study was to compare venous and arterial blood flow between the right and left kidney in the third trimester in women without known pregnancy complications.Methods: We conducted a prospective cohort study in 50 women with uncomplicated third-trimester pregnancies at Trondheim University Hospital, Norway, from January to April 2018. The arterial and venous blood flow were examined with pulsed wave Doppler in the hilum of the kidneys and the cross section of the area (CSA) of the vessels was measured from 3D acquisitions. Two diameters of the main vein and artery were measured after rotating the image of the vessels in the C-plane to be as circular as possible. CSA was calculated as p×(mean diameter/2)2. Blood flow volume (ml/minute) in the vessels were calculated as 0.5?×?TAmax (cm/s)×CSA (cm2)×60. The main outcome was venous and arterial blood flow volumes, and secondary outcomes were maximum velocity (Vmax), minimum velocity (Vmin), pulsatile index (PI), time-averaged maximum flow (TAmax) and renal interolobar vein impedance index (RIVI). We also examined possible associations between blood flow and maternal age, BMI and blood pressure.Results: We observed differences in venous flow parameters between the two kidneys. The mean total flow volume in the renal veins was 274?ml/min in the left vein versus 358?ml/min in the right vein (p=.10). Vmax, TAmax, PI, and RIVI were all significantly lower in the left renal vein. No differences in arterial blood flow between the two kidneys were found. BMI was negatively correlated to flow in the left renal vein (r=?-0.28; p
PubMed ID
30422736 View in PubMed
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10 records – page 1 of 1.