Predictors of renal outcomes and mortality in patients with renal vein thrombosis: a retrospective multicenter study

Osama Nady Mohamed; Sharehan Abdelrahman Ibrahim; Shereen Mohammed Mohammed Elsaghir; Marwa Ibrahim Mohamed; Basma Fathy; Ahmed M Dardeer; Sayed Shehata; Hassan M H Mohammed; Amr Setouhi; Ayat Mostafa Mohamed Ahmed; Asmaa Khalf Kamel; Doaa Elzaeem Ismail; Nehal I Abbas; Ahmed Fathy Kamel Ziady; Tamer El Zaeem Esmaeel; Ahmed S Issa; Ahmed M Yassin; Mostafa Mahmoud Hussein; Mostafa M Abdelghany; Momen Mostafa Nagy; Michael Samuel Ayad; Shaimaa F Kamel

doi:10.1007/s40620-024-02166-5

Predictors of renal outcomes and mortality in patients with renal vein thrombosis: a retrospective multicenter study

J Nephrol. 2024 Dec 31. doi: 10.1007/s40620-024-02166-5. Online ahead of print.

Authors

Osama Nady Mohamed¹, Sharehan Abdelrahman Ibrahim², Shereen Mohammed Mohammed Elsaghir², Marwa Ibrahim Mohamed², Basma Fathy², Ahmed M Dardeer³, Sayed Shehata³, Hassan M H Mohammed³, Amr Setouhi³, Ayat Mostafa Mohamed Ahmed⁴, Asmaa Khalf Kamel⁴, Doaa Elzaeem Ismail⁴, Nehal I Abbas⁴, Ahmed Fathy Kamel Ziady⁵, Tamer El Zaeem Esmaeel⁵, Ahmed S Issa⁵, Ahmed M Yassin⁵, Mostafa Mahmoud Hussein⁶, Mostafa M Abdelghany⁶, Momen Mostafa Nagy⁶, Michael Samuel Ayad⁶, Shaimaa F Kamel²

Affiliations

¹ Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Minia University, Taha Hussein Street, Minia, Egypt. [email protected].
² Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Minia University, Taha Hussein Street, Minia, Egypt.
³ Department of Cardiology, Faculty of Medicine, Minia University, Minia, Egypt.
⁴ Department of Clinical Pathology, Faculty of Medicine, Minia University, Minia, Egypt.
⁵ Department of Radiology, Faculty of Medicine, Minia University, Minia, Egypt.
⁶ Department of Vascular Surgery, Faculty of Medicine, Minia University, Minia, Egypt.

PMID: 39739269
DOI: 10.1007/s40620-024-02166-5

Abstract

Background: Studies on renal vein thrombosis have been conducted as case reports or case series. The renal outcomes and mortality risk of renal vein thrombosis have not been fully established. We aimed to investigate the clinical characteristics, treatment modalities, and predictors of renal outcomes and mortality in patients with renal vein thrombosis in a large multicenter cohort.

Methods: We retrospectively assessed 182 patients with renal vein thrombosis diagnosed between January 2011 and May 2023 using either Doppler ultrasonography or computed tomography venography. The main outcomes analyzed were all-cause mortality, and worsening kidney function.

Results: We evaluated 182 patients comprising 76 males (41.8%) and 106 females (58.2%). Nephrotic syndrome was the most common cause (51.6%) followed by malignancy (33%) and post-trauma or surgery (11%). Kidney function worsened in 126 patients (69.2%). Acute kidney injury (AKI) was identified in 72 patients (39.6%), whereas 54 patients (29.7%) developed chronic kidney disease (CKD). Multivariate logistic regression showed that declining kidney function was reliably predicted by nephrotic syndrome (Odds ratio (OR): 6.41, P = 0.004), serum albumin (OR: 0.31, P = 0.003), and diabetes mellitus (OR: 14.04, P < 0.001). Eighty-two patients (45.1%) died while being monitored. Sepsis accounted for the majority of deaths (25.3%). Bilateral renal vein thrombosis (Hazard Ratio (HR): 5.61, P < 0.001), malignancy (HR: 6.15, P = 0.004), serum albumin (HR: 0.12, P < 0.001), hemoglobin (Hb) level (HR: 0.102, P < 0.001) and diabetes mellitus (HR: 2.42, P = 0.007) were all reliable predictors of all-cause mortality using multivariate Cox regression.

Conclusion: Renal vein thrombosis is associated with a higher risk of mortality and worsening kidney function. It is essential to promptly identify high risk patients and start early treatment to prevent unfavorable outcomes.

Keywords: Chronic kidney disease; Malignancy; Nephrotic syndrome; Renal vein thrombosis.