Inferior vena cava thrombosis as a possible cause of nephrotic-range proteinuria: two case reports

Abstract Background Nephrotic-range proteinuria is a common reason for nephrological consultation in clinical practice. The differential diagnosis is wide, and generally focuses on different forms of glomerulonephritis, but other causes should not be overlooked, as illustrated in this article. Case...

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Autores principales:	Yana Apostolova, Patricia Mehier, Salah D. Qanadli, Menno Pruijm
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Nephrotic syndrome Inferior vena cava Orthostatic proteinuria Medicine R
Acceso en línea:	https://doaj.org/article/af7bb274e927416ca9a9650bd0638546
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spelling	oai:doaj.org-article:af7bb274e927416ca9a9650bd06385462021-11-28T12:37:16ZInferior vena cava thrombosis as a possible cause of nephrotic-range proteinuria: two case reports10.1186/s13256-021-03132-61752-1947https://doaj.org/article/af7bb274e927416ca9a9650bd06385462021-11-01T00:00:00Zhttps://doi.org/10.1186/s13256-021-03132-6https://doaj.org/toc/1752-1947Abstract Background Nephrotic-range proteinuria is a common reason for nephrological consultation in clinical practice. The differential diagnosis is wide, and generally focuses on different forms of glomerulonephritis, but other causes should not be overlooked, as illustrated in this article. Case presentations We report two female patients with nephrotic-range proteinuria. In the first case, a 46 year old Caucasian patient who suffered from extreme obesity (Body mass index (BMI) 77 kg/m2), acute kidney injury and nephrotic-range proteinuria were discovered during an emergency consultation for acute abdominal pain. The second patient (aged 52, also Caucasian) developed stage 4 chronic kidney disease and nephrotic proteinuria (protein/creatinine ratio 1821 g/mol) after accidental rupture of the inferior vena cava during a gastric bypass operation. On split-urine collection, both had a much higher degree of proteinuria during the day than during the night, compatible with orthostatic proteinuria. At further work-up, inferior vena cava thrombosis was diagnosed in both patients, whereas renal veins were patent. Discussion After simple anticoagulation in the first case, and anticoagulation plus endovascular recanalization in the second, there was almost complete resolution of the orthostatic proteinuria and a strong improvement of the estimated glomerular filtration rate in both patients. These cases highlight that nephrotic-range proteinuria can be linked to inferior vena cava thrombosis, and that a split-urine collection may also be very useful in the diagnostic work-up of proteinuria in adults.Yana ApostolovaPatricia MehierSalah D. QanadliMenno PruijmBMCarticleNephrotic syndromeInferior vena cavaOrthostatic proteinuriaMedicineRENJournal of Medical Case Reports, Vol 15, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Nephrotic syndrome Inferior vena cava Orthostatic proteinuria Medicine R
spellingShingle	Nephrotic syndrome Inferior vena cava Orthostatic proteinuria Medicine R Yana Apostolova Patricia Mehier Salah D. Qanadli Menno Pruijm Inferior vena cava thrombosis as a possible cause of nephrotic-range proteinuria: two case reports
description	Abstract Background Nephrotic-range proteinuria is a common reason for nephrological consultation in clinical practice. The differential diagnosis is wide, and generally focuses on different forms of glomerulonephritis, but other causes should not be overlooked, as illustrated in this article. Case presentations We report two female patients with nephrotic-range proteinuria. In the first case, a 46 year old Caucasian patient who suffered from extreme obesity (Body mass index (BMI) 77 kg/m2), acute kidney injury and nephrotic-range proteinuria were discovered during an emergency consultation for acute abdominal pain. The second patient (aged 52, also Caucasian) developed stage 4 chronic kidney disease and nephrotic proteinuria (protein/creatinine ratio 1821 g/mol) after accidental rupture of the inferior vena cava during a gastric bypass operation. On split-urine collection, both had a much higher degree of proteinuria during the day than during the night, compatible with orthostatic proteinuria. At further work-up, inferior vena cava thrombosis was diagnosed in both patients, whereas renal veins were patent. Discussion After simple anticoagulation in the first case, and anticoagulation plus endovascular recanalization in the second, there was almost complete resolution of the orthostatic proteinuria and a strong improvement of the estimated glomerular filtration rate in both patients. These cases highlight that nephrotic-range proteinuria can be linked to inferior vena cava thrombosis, and that a split-urine collection may also be very useful in the diagnostic work-up of proteinuria in adults.
format	article
author	Yana Apostolova Patricia Mehier Salah D. Qanadli Menno Pruijm
author_facet	Yana Apostolova Patricia Mehier Salah D. Qanadli Menno Pruijm
author_sort	Yana Apostolova
title	Inferior vena cava thrombosis as a possible cause of nephrotic-range proteinuria: two case reports
title_short	Inferior vena cava thrombosis as a possible cause of nephrotic-range proteinuria: two case reports
title_full	Inferior vena cava thrombosis as a possible cause of nephrotic-range proteinuria: two case reports
title_fullStr	Inferior vena cava thrombosis as a possible cause of nephrotic-range proteinuria: two case reports
title_full_unstemmed	Inferior vena cava thrombosis as a possible cause of nephrotic-range proteinuria: two case reports
title_sort	inferior vena cava thrombosis as a possible cause of nephrotic-range proteinuria: two case reports
publisher	BMC
publishDate	2021
url	https://doaj.org/article/af7bb274e927416ca9a9650bd0638546
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Inferior vena cava thrombosis as a possible cause of nephrotic-range proteinuria: two case reports

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