CLINICAL ASPECTS OF RENAL VEIN THROMBOSIS1

EXAMPLES of renal vein thrombosis, with or without obstruction of the inferior vena cava, have frequently been reported since the original description by Rayer (1840-1). In the past most cases have been first recognized at necropsy, but it should now be possible to make the diagnosis clinically. This paper describes 11 patients, in some of whom the condition was either recognized or suspected in life on clinical grounds, and in four of whom it was confirmed radiologically. An attempt is made to distinguish cases in which renal disease is secondary to caval or renal-vein obstruction from those in which the thrombosis is produced by primary renal disease. Three patients clinically presented the nephrotio syndrome, and six a rapid deterioration of renal function with oliguria. One patient was a typical example of tumour-thrombosis of the renal vein and inferior vena cava, and in the remaining case obstruction of the renal vein was associated with malignant hypertension. The cases described comprise seven patients seen at Hammersmith Hospital from 1953 to 1955, three cases (Nos. 1, 9, and 11) from the hospital records, and one patient (No. 5) seen at anothe