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Risk factors of worsening kidney function and mortality in patients with renal vein thrombosis: a retrospective study

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Abstract

Background

The outcome of renal vein thrombosis, in particular as for the long-term impact on kidney function, is not fully known. We aimed to study the natural course and outcomes of patients with renal vein thrombosis, in a large, single-center cohort.

Methods

A single-center retrospective cohort study including patients who were diagnosed with renal vein thrombosis between January 2006 and September 2021 was analyzed. The main outcomes analyzed were worsening kidney function, defined as a decrease in eGFR of at least 40% from baseline, and all-cause mortality.

Results

Eighty-seven patients were included, 56.3% were female, median age was 57 years. Malignancy was the most common cause of renal vein thrombosis (60.9%), followed by post-surgery and trauma (16.1%) and nephrotic syndrome (12.6%). At initial presentation, 65.5% of the patients were asymptomatic; the main signs and symptoms were gross hematuria (20.7%), flank pain (18.4%), and flank tenderness (9.2%). During follow-up, 18 (21.4%) patients experienced worsening kidney function and 57 (65.5%) died. Multivariable analyses showed that the risk of worsening kidney function was higher in patients with nephrotic syndrome (hazard ratio [HR] 18.41; 95% confidence interval [CI], 1.57–216.04), body weight ≥ 60 kg (HR 4.82; 95% CI 1.43–16.32), and malignancy (HR 9.10; 95% CI 1.05–78.63). Symptomatic acute renal vein thrombosis was associated with a lower risk of worsening kidney function compared to asymptomatic or symptomatic chronic renal vein thrombosis (HR 0.12; 95% CI 0.01–0.96). Malignancy (HR 5.45; 95% CI 2.58–11.54), age ≥ 75 years (HR 3.44; 95% CI 1.49–7.93), and serum albumin < 3.0 g/dL (HR 2.88; 95% CI 1.65–5.05) were associated with an increased mortality risk.

Conclusion

Renal vein thrombosis is associated with a high rate of worsening kidney function and mortality. It is crucial to promptly identify patients at high risk and initiate early treatment to prevent negative outcomes.

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Data availability

This study does not cover data posting in public databases. However, data are available upon reasonable request to the corresponding author and are subject to approval by Faculty of Medicine, Chiang Mai University Ethics Committee.

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Funding

No funding was received for conducting this study.

Author information

Authors and Affiliations

  1. Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

    Puttinat Wanaratwichit & Kajohnsak Noppakun

  2. Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

    Chatree Chai-Adisaksopha

  3. Division of Intervention Radiology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

    Nakarin Inmutto

  4. Pharmacoepidemiology and Statistics Research Center, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand

    Kajohnsak Noppakun

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  1. Puttinat Wanaratwichit
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  4. Kajohnsak Noppakun
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Contributions

Conceptualization: PW, CC-A, KN; Methodology: PW, CC-A, NI; Formal analysis and investigation PW, CC-A, KN; Writing—original draft preparation: PW, CC-A; Writing—review and editing: CC-A, KN; Supervision: CC-A, KN. Each author contributed important intellectual content during manuscript drafting or revision and agrees to be personally accountable for the individual’s own contributions and to ensure that questions pertaining to the accuracy or integrity of any portion of the work, even one in which the author was not directly involved, are appropriately investigated and resolved, including with documentation in the literature if appropriate.

Corresponding authors

Correspondence to Chatree Chai-Adisaksopha or Kajohnsak Noppakun.

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Conflict of interest

The authors did not receive support from any organization for the submitted work. All authors certify that they have no affiliations with, or involvement in, any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

The study was performed in accordance with the Declaration of Helsinki and the Declaration of Istanbul. It was approved by the Institutional Review Boards of Chiang Mai University (approval number: MED-2564-08529).

Informed consent

Informed consent was waived because of the retrospective nature of the study, and the analysis used anonymous clinical data.

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Wanaratwichit, P., Chai-Adisaksopha, C., Inmutto, N. et al. Risk factors of worsening kidney function and mortality in patients with renal vein thrombosis: a retrospective study. J Nephrol 37, 131–140 (2024). https://doi.org/10.1007/s40620-023-01761-2

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