Neonatal renal venous thrombosis in Germany between 1992 and 1994: epidemiology, treatment and outcome

Renal venous thrombosis (RVT) occurs mainly in the neonatal period and bear s a dismal prognosis for individual kidney function. There is no generally accepted therapeutic regimen as controlled clinical trials are lacking. Ove r the last few years, thrombolytic therapy has been successfully employed b y single centres. The present study set out to gather up-to-date informatio n on the incidence, therapy and outcome of neonatal RVT as part of a prospe ctive nation wide survey on neonatal thrombosis in Germany to serve as a ba sis for therapeutic trials in the future. Between 1992 and 1994 the minimum incidence of symptomatic neonatal RVT in Germany was 2.2 per 100,000 live births (95% confidence interval 1.4-3.3). Out of 35 cases, RVT occurred in 15 premature babies (incidence 13 per 100,000 live births (95% confidence i nterval 5.9-24.8). Ten babies had associated caval occlusion. Therapy was s upportive in 8, low dose heparin was used in 14, full heparinization in 9 a nd thrombolytic therapy in 4 children. On. follow-up after a median time of 11.5 months, renal atrophy was present in 26 out of 39 affected kidneys. Conclusion Neonatal renal venous thrombosis still leads to irreversible kid ney damage in the majority of cases. Because of the low incidence a multi-n ational multi-centre therapeutic trial over a long period has to be conside red in order to determine the optimal therapeutic approach.