Renal vein and artery throbosis in newborn and children

In newborns, renal thromboembolism has been associated most frequently with umbilical artery catheters. In children, the most common renal disorder associated with hemostatic complications is renal vein thrombosis. The main causes are severe dehydration secondary to sepsis, nephrotic syndrome and related glomerulonephropathy and congenital disorders of hemostasis. Clinical features of the condition in newborns and young children include enlarged kidneys, gross hematuria, thrombocytopenia, hypertension and kidney failure. The severity of the condition depends on whether one or both kidneys are involved. Clinical evaluation is feasible with ultrasound and scintigraphy as well as with other imaging tecniques. The treatment, either pharmacological or surgical, presents both benefits and risks. The prognosis, which is generally poor, champions the need for prevention of thromboembolism and a prompt diagnosis is essential in order to begin appropriate therapy and relative follow-up. Late sequelae include impairment of renal function, shrunken hypoplastic kidney, arterial hypertension and tubular defects. In this chapter, conditions concerning venous or arterial thrombosis associated with terminal renal failure, renal transplantation or tumors are not covered