Thrombolyse bei Nierenvenenthrombosen. Eine Literaturubersicht

Acute obstruction of the renal venous circulation leads to kidney atrophy due to hemorrhagic infarction in the majority of cases. On pathoanatomic grounds two types can be distinguished: renal venous thrombosis originating in small intrarenal veins and renal vein thrombosis - the adult type with origin in the main renal vein. Reports on the effect of thrombolytic agents in these conditions are sparse in the neonate. In a review of the literature 26 reports describing 37 patients with renal venous or renal vein thrombosis receiving thrombolytic therapy were found. Five out of 18 organs with renal vein thrombosis showed atrophy on follow-up (28%). Scarring was noted in 12 out of 30 kidneys with renal venous thrombosis (40%). These data compare favourably with results published for supportive or anticoagulant therapy. In order to determine the optimal treatment for renal venous and renal vein thrombosis, a prospective randomized trial is needed.