A neonate may develop thrombosis of a renal vein if certain risk factors are present. A clinical suspicion can be verified by appropriate diagnostic testing.


Risk factors for renal vein thrombosis in a neonate:

(1) polycythemia

(2) dehydration

(3) maternal gestational diabetes (associated with polycythemia and respiratory distress)

(4) asphyxia

(5) sepsis

(6) hypercoagulable state (protein C deficiency, antithrombin III deficiency, congenital)


Clinical findings seen in renal vein thrombosis:

(1) solid flank mass (in both flanks if bilateral)

(2) hematuria

(3) hypertension

(4) thrombocytopenia

(5) possibly oliguria


The presence of clinical findings in a newborn infant with one or more risk factors should prompt ultrasonography or other diagnostic study.


If an underlying cause is not identified, then the infant should be evaluated for a hypercoagulable state. Since blood samples from a neonate may be difficult to collect the parents can be evaluated if a hereditary defect (Factor V Leiden, Prothrombin G20210A) is suspected.


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