What kidney complication can Deep Vein Thrombosis (DVT) cause?

From the Guidelines

Deep Vein Thrombosis (DVT) can cause renal vein thrombosis as a kidney complication, which may lead to impaired kidney function, kidney damage, and potentially kidney failure. This occurs when a blood clot that forms in the deep veins, typically in the legs, breaks off and travels through the bloodstream, potentially lodging in the renal veins that drain blood from the kidneys. According to the 2023 study 1, venous thromboembolic disease is a cause of morbidity in patients with nephrotic syndrome, and treatment doses of unfractionated or low-molecular-weight heparin or warfarin are preferred for treatment or prevention in those with thromboembolic risk greater than bleeding risk.

Key Points to Consider

• Renal vein thrombosis can cause impaired kidney function, kidney damage, and in severe cases, kidney failure
• The blockage prevents normal blood flow from the kidney, causing increased pressure in the kidney's small blood vessels, which can damage the filtering units (nephrons)
• Symptoms may include flank pain, decreased urine output, blood in the urine, and worsening kidney function tests
• Treatment typically involves anticoagulation therapy with medications like heparin initially, followed by warfarin or direct oral anticoagulants (DOACs) such as apixaban or rivaroxaban for 3-6 months or longer, as noted in the study 1
• The risk of this complication increases in patients with nephrotic syndrome, dehydration, or hypercoagulable states

Important Considerations for Treatment

• Prompt diagnosis and treatment of DVT are essential to prevent this and other serious complications
• The study 1 highlights the importance of considering the thromboembolic risk versus bleeding risk when selecting treatment options
• Factor Xa inhibitors and direct thrombin inhibitors have significant/moderate albumin binding and are therefore lost in nephrotic urine, and pharmacokinetics are not well studied, making them less preferred options at this time, as stated in the study 1

From the Research

Kidney Complications Caused by DVT

• Deep Vein Thrombosis (DVT) can cause kidney complications, particularly in patients with chronic kidney disease (CKD) or nephrotic syndrome 2, 3, 4, 5, 6.
• One of the kidney complications caused by DVT is renal vein thrombosis (RVT), which is a blood clot that forms in the veins that carry blood away from the kidneys 3, 4, 5.
• RVT can lead to kidney damage, kidney failure, and even death if left untreated 3, 4, 5.
• Patients with nephrotic syndrome are at higher risk of developing RVT due to their increased risk of blood clots 2, 3, 4, 5, 6.
• Treatment of RVT usually involves anticoagulation therapy, such as low-molecular-weight heparin or warfarin, to prevent further blood clots from forming 3, 4, 5, 6.
• In some cases, patients with RVT may require outpatient treatment with low-molecular-weight heparin, which has been shown to be effective and safe 4.
• Newer anticoagulants, such as rivaroxaban, have also been used to treat RVT in patients with nephrotic syndrome, with favorable results 5.
• Prophylaxis of thromboembolic events in patients with nephrotic syndrome is crucial to prevent kidney complications, and may involve the use of low-molecular-weight heparin or other anticoagulants 6.