Abstract
References
- 1) Avgerinos ED, McEnaney R, Chaer RA. Surgical and endovascular interventions for nutcracker syndrome. Semin Vasc Surg 2013;26:170-77.
- 2) Alaygut D, Bayram M, Soylu A, Cakmakcı H, Türkmen M, Kavukcu S. Clinical course of children with nutcracker syndrome. Urology 2013;82:686-90.
- 3) Ananthan K, Onida S, Davies AH. Nutcracker Syndrome: An Update on Current Diagnostic Criteria and Management Guidelines. Eur J Vasc Endovasc Surg 2017;53:886-94
- 4) Venkatachalam S, Bumpus K, Kapadia SR, Gray B, Lyden S, Shishehbor MH. The nutcracker syndrome. Ann Vasc Surg 2011;25:1154-64. 5) Shin JI, Lee JS. Nutcracker phenomenon or nutcracker syndrome? Nephrol Dial Transplant 2005;20:2015. doi: 10.1093/ndt/gfi078.
- 6)Kargın Çakıcı E, Yazılıtaş F, Çınar HG, Can G, Kurt Şükür ED, Güngör T, ark. Çocuklarda Nutcracker Syndrome: Doppler UltrasonografininSemptomatik Hastalardaki Rolü Türkiye Çocuk Hast Derg/Turkish J Pediatr Dis / 2019; 5: 348-52
- 7) ) Kim SH. Doppler US and CT diagnosis of Nutcracker Syndrome. Korean J Radiol 2019; 20(12):1627-37
- 8) Gulleroglu K, Gulleroglu B, Baskin E. Nutcracker syndrome. World J Nephrol 2014;3: 277-81. 9)Kim KW, Cho JY, Kim SH, Yoon JH, Kim DS, Chung JW, et al. Diagnostic value of computed tomographic findings of nutcracker syndrome: correlation with renal venography and renocaval pressure gradients. Eur J Radiol 2011;80:648-54
- 10) Ha TS, Lee EJ. ACE inhibition can improve orthostatic proteinuria associated with nutcracker syndrome. Pediatr Nephrol 2006;21(11):1765-1768
- 11)Zhang H, Li M, Jin W, San P, Xu P, Pan S. The left renal entrapment syndrome: diagnosis and treatment. Ann Vasc Surg 2007;21:198-203.
- 12)Praveen M, Suseelamma D, Saritha S. Multiple renal vascular variations. Open Access Scic Rep 2012;1:334.
- 13) Kurç E, Barutca H, Kanyılmaz M, Sargın M, Şahin S. Nutcracker Syndrome. Turk Gogus Kalp Damar 2013;21:146-50.
- 14) Shin JI, Lee JS. ACE inhibition in nutcracker syndrome with orthostatic proteinuria: how about a hemodynamic effect? Pediatr Nephrol 2007;22:758. author reply 759-60
- 15) Takahashi Y, Sano A,MatsuoM. An effective “transluminal balloon angioplasty” therapy for pediatric chronic fatigue syndrome with nutcracker phenomenon. Clin Nephrol 2000;53:77-8.
- 16) Park SJ, Lim JW, Ko YT, Lee DH, Yoon Y, Oh JH, et al. Diagnosis of pelvic congestion syndrome using transabdominal and transvaginal sonography. AJR Am J Roentgenol 2004;182: 683-88.
- 17) Pascarella L, Penn A, Schmid-Schonbein GW. Venous hypertension and the inflammatory cascade: major manifestations and trigger mechanisms. Angiology 2005;56(Suppl. 1):S3-10.
- 18) De Schepper A. “Nutcracker” phenomenon of the renal vein and venous pathology of the left kidney. Radiology 1972; 55: 507-11.
- 19) Li H, Sun X, Liu G, Zhang Y, Chu J, Deng C, et al. Endovascular stent placement for nutcracker phenomenon. J Xray Sci Technol 2013; 21: 95-102
- 20) Tanaka H, Waga S. Spontaneous remission of persistent severe hematuria in an adolescent with nutcracker syndrome seven years observation. Clin Exp Nephrol. 2004;8:68-70.
- 21) Fuhrman DY, Schneider MF, Dell KM, et al. Albuminuria, Proteinuria, and Renal Disease Progression in Children with CKD. Clin J Am Soc Nephrol 2017;12:912-20
Abstract
Objective: It has been aimed to report the experience of our center regarding diagnosis and treatment experience in children with Nutcracker syndrome (NCS).
Materials and Methods: The medical records of the seven patients who have admitted to the Department of Pediatric Nephrology of our hospital between February 2017 and March 2020 were evaluated retrospectively. The diagnosis of NCS was confirmed with renal Doppler ultrasound (RDUS) and magnetic resonance angiography (MRA) in these patients who have admitted with the complaints of hematuria and proteinuria. The patient data such as clinical characteristics, radiological findings, radiological signs and information about the applied medical treatment at baseline and the last control examination were recorded.
Results: The mean levels of 24-h urine protein excretion in all the patients at baseline and the last control examination were 15,25±9,19 mg/m2/h and 9,8±3,94 mg/m2/h, respectively. The mean levels of 24-h urine protein excretion in the patients treated with ACE (angiotensin converting enzyme) inhibitor at baseline and the last control examination were 20±11,53 mg/m2/h and 9,6±6,44 mg/m2/h, respectively. (p=0,073). The mean levels of 24-h urine protein excretion were 11.7±6.39 mg/m2/h and 9.95±1.84 mg/m2/h in the patients not receiving ACE inhibitor treatment, at baseline and the last control examination respectively (p= 0,61). The mean angle value of the left renal vein in the aortomesenteric distance measured by RDUS examination performed in the upright position was 14,71±4,46 degrees. The anteroposterior diameter of the left renal vein (hilar/aortomesenteric) measured in the upright position was 6,4.
Conclusion: The benign nature of NCS in young patients requires maintaining conservative approach.
References
- 1) Avgerinos ED, McEnaney R, Chaer RA. Surgical and endovascular interventions for nutcracker syndrome. Semin Vasc Surg 2013;26:170-77.
- 2) Alaygut D, Bayram M, Soylu A, Cakmakcı H, Türkmen M, Kavukcu S. Clinical course of children with nutcracker syndrome. Urology 2013;82:686-90.
- 3) Ananthan K, Onida S, Davies AH. Nutcracker Syndrome: An Update on Current Diagnostic Criteria and Management Guidelines. Eur J Vasc Endovasc Surg 2017;53:886-94
- 4) Venkatachalam S, Bumpus K, Kapadia SR, Gray B, Lyden S, Shishehbor MH. The nutcracker syndrome. Ann Vasc Surg 2011;25:1154-64. 5) Shin JI, Lee JS. Nutcracker phenomenon or nutcracker syndrome? Nephrol Dial Transplant 2005;20:2015. doi: 10.1093/ndt/gfi078.
- 6)Kargın Çakıcı E, Yazılıtaş F, Çınar HG, Can G, Kurt Şükür ED, Güngör T, ark. Çocuklarda Nutcracker Syndrome: Doppler UltrasonografininSemptomatik Hastalardaki Rolü Türkiye Çocuk Hast Derg/Turkish J Pediatr Dis / 2019; 5: 348-52
- 7) ) Kim SH. Doppler US and CT diagnosis of Nutcracker Syndrome. Korean J Radiol 2019; 20(12):1627-37
- 8) Gulleroglu K, Gulleroglu B, Baskin E. Nutcracker syndrome. World J Nephrol 2014;3: 277-81. 9)Kim KW, Cho JY, Kim SH, Yoon JH, Kim DS, Chung JW, et al. Diagnostic value of computed tomographic findings of nutcracker syndrome: correlation with renal venography and renocaval pressure gradients. Eur J Radiol 2011;80:648-54
- 10) Ha TS, Lee EJ. ACE inhibition can improve orthostatic proteinuria associated with nutcracker syndrome. Pediatr Nephrol 2006;21(11):1765-1768
- 11)Zhang H, Li M, Jin W, San P, Xu P, Pan S. The left renal entrapment syndrome: diagnosis and treatment. Ann Vasc Surg 2007;21:198-203.
- 12)Praveen M, Suseelamma D, Saritha S. Multiple renal vascular variations. Open Access Scic Rep 2012;1:334.
- 13) Kurç E, Barutca H, Kanyılmaz M, Sargın M, Şahin S. Nutcracker Syndrome. Turk Gogus Kalp Damar 2013;21:146-50.
- 14) Shin JI, Lee JS. ACE inhibition in nutcracker syndrome with orthostatic proteinuria: how about a hemodynamic effect? Pediatr Nephrol 2007;22:758. author reply 759-60
- 15) Takahashi Y, Sano A,MatsuoM. An effective “transluminal balloon angioplasty” therapy for pediatric chronic fatigue syndrome with nutcracker phenomenon. Clin Nephrol 2000;53:77-8.
- 16) Park SJ, Lim JW, Ko YT, Lee DH, Yoon Y, Oh JH, et al. Diagnosis of pelvic congestion syndrome using transabdominal and transvaginal sonography. AJR Am J Roentgenol 2004;182: 683-88.
- 17) Pascarella L, Penn A, Schmid-Schonbein GW. Venous hypertension and the inflammatory cascade: major manifestations and trigger mechanisms. Angiology 2005;56(Suppl. 1):S3-10.
- 18) De Schepper A. “Nutcracker” phenomenon of the renal vein and venous pathology of the left kidney. Radiology 1972; 55: 507-11.
- 19) Li H, Sun X, Liu G, Zhang Y, Chu J, Deng C, et al. Endovascular stent placement for nutcracker phenomenon. J Xray Sci Technol 2013; 21: 95-102
- 20) Tanaka H, Waga S. Spontaneous remission of persistent severe hematuria in an adolescent with nutcracker syndrome seven years observation. Clin Exp Nephrol. 2004;8:68-70.
- 21) Fuhrman DY, Schneider MF, Dell KM, et al. Albuminuria, Proteinuria, and Renal Disease Progression in Children with CKD. Clin J Am Soc Nephrol 2017;12:912-20
Details
| Primary Language | English |
|---|---|
| Subjects | Paediatrics |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | July 1, 2021 |
| Submission Date | March 17, 2021 |
| Published in Issue | Year 2021Volume: 12 Issue: 3 |
