Clinical Characteristics and Long-term Follow-up of Patients With Renal Vein Thrombosis

Waldemar E. Wysokinski, Izabela Gosk-Bierska, Eddie L. Greene, Diane Grill, Heather Wiste, Robert D. McBane

Research output: Contribution to journalArticle

43 Scopus citations

Abstract

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. Study Design: 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. Setting & Participants: All patients with a diagnosis of RVT at Mayo Clinic from 1980 to 2000. Outcomes & Measures: 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). Limitations: 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.

Original languageEnglish (US)
Pages (from-to)224-232
Number of pages9
JournalAmerican Journal of Kidney Diseases
Volume51
Issue number2
DOIs
StatePublished - Feb 1 2008

Keywords

  • Renal vein thrombosis
  • nephrotic syndrome
  • renal cell cancer

ASJC Scopus subject areas

  • Nephrology

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    Wysokinski, W. E., Gosk-Bierska, I., Greene, E. L., Grill, D., Wiste, H., & McBane, R. D. (2008). Clinical Characteristics and Long-term Follow-up of Patients With Renal Vein Thrombosis. American Journal of Kidney Diseases, 51(2), 224-232. https://doi.org/10.1053/j.ajkd.2007.10.030