55 - Management strategies of neonatal renal vein thrombosis: A call for international collaborations utilizing the International Pediatric Thrombosis Network (IPTN).

Poster Number: 55
Publication Number: 55.2006

Background: Perinatal renal vein thrombosis is a disease with low mortality but high morbidity. We have previously reviewed the English literature between 1992 and 2006 but no evidence -based recommendations for optimal management were able to be made. We conducted another English literature review between 2007 to 2023 to further explore the possibility to come up with guidelines in the management of this condition.

Objective: We aimed to collect available data to help optimizing the management approaches and strategies of neonatal renal vein thrombosis.

Design/Methods: Relevant literature from PubMed, EMBASE and CINAHL were systematically searched using the following criteria: 1. Renal Vein Thrombosis; 2. Neonates; 3. English language. All relevant articles were reviewed and the extracted data were put in the same format as our last study for further analysis.

Results: A total of 61 neonates from 26 reports were included for analysis. There were 46 (75%) male and 12 (20%) female. Information on sex was absent in 3 (5%) of the neonates. Left and right kidneys were affected in 19 (31%) and 18 (30%) patients respectively. Bilateral renal involvement was present in 25 (39%) neonates. Inferior vena cava thrombosis was documented in 39 (64%) infants. Fifty-nine (97%) of the neonates had documented therapeutic modalities. Out of these 59 patients, 17 (29%) and 18 (31%) received no treatment or non-specific anticoagulation. Unfractionated heparin and low molecular weight heparin were given to 7 (12%) and 12 (20%) of patients. Three (5%) of the neonates had their anticoagulation changed from one to another during the course. One neonate received only warfarin and another one received only thrombolytic. Concomitant thrombolytic therapies were administered in addition to anticoagulation in 9 (15%) babies. In those patients with documented outcomes, complete resolution and kidney atrophy +/- nephrectomy +/- renal failure were reported in 23% and 77% respectively.

Conclusion(s): After reviewing 30 years of English literature, evidence-based recommendations on management of patients with perinatal renal vein thrombosis still cannot be made. Prospective studies in stratified risk groups are in dire needs to elucidate the optimal management in neonates with renal vein thrombosis and possibly do this through International Pediatric Thrombosis Network.