RENAL VEIN THROMBOSIS: CLINICAL MANIFESTATIONS AND SURGICAL EVALUATION

Abstract

Renal vein thrombosis is a serious condition that can lead to kidney damage, renal failure, and thromboembolic complications. Clinical manifestations depend on the cause, extent and rapidity of renal vein occlusion. Some people may have no symptoms, while others may experience pain, fever, nausea, vomiting, blood in the urine, and decreased urine production. In more serious cases, kidney infarction or pulmonary embolism may occur. Objective: to evaluate the scientific evidence on the clinical manifestations and surgical evaluation of renal vein thrombosis in adults. Methodology: The methodology followed the PRISMA checklist, the databases used were PubMed, Scielo, Web of Science and the descriptors used were: Renal vein thrombosis, clinical manifestations, surgical evaluation, treatment and prognosis. Articles published in the last 10 years (2013-2023), in Portuguese or English, that addressed the proposed topic were included. Articles that were not systematic reviews or meta-analyses, that did not have an abstract available, that did not present sufficient data for analysis or that had low methodological quality were excluded. Results: 15 studies were selected. The main topics covered were: the causes and risk factors for renal vein thrombosis; the most used diagnostic methods and their accuracy; the treatment options available and their effectiveness; the complications and prognosis of patients with renal vein thrombosis; and knowledge gaps and recommendations for clinical practice and future research. Conclusion: Early diagnosis and appropriate treatment can improve the survival and quality of life of patients with renal vein thrombosis. Surgical evaluation is indicated in some cases, especially when there is suspicion of a malignant renal tumor, extrinsic compression or migratory thrombophlebitis. Surgery may involve removing the clot (thrombectomy), removing the affected kidney (nephrectomy), or placing a stent in the renal vein to restore blood flow. Non-surgical treatment usually includes anticoagulant and fibrinolytic medications. Additionally, it is important to treat the underlying cause of thrombosis, such as nephrotic syndrome, diabetes, lupus, or hypercoagulable diseases. More studies are needed to compare different treatment modalities and evaluate the long-term outcomes of patients with renal vein thrombosis.