The Role of Left Renal Vein Entrapment Phenomenon in Children with Asymptomatic Non-glomerular Hematuria / 대한신장학회잡지

ABSTRACT

PURPOSE: Left renal vein entrapment syndrome has been suggested as an etiology for asymptomatic non-glomerular hematuria since it was reported as a cause of unilateral gross hematuria. Reported diagnostic criteria has been controversial since various degrees of left renal vein entrapment was found in normal children. Some of asymptomatic non-glomerular hematuria was not diagnosed even with renal biopsies but was usually known to have self-limited benign course. We analyzed the relationship between asymptomatic non-glomerular hematuria of unknown origin and the degree of left renal vein entrapment phenomenon. METHODS: The renal doppler sonograpy of 92 children with asymptomatic non-glomerular hematuria [gross hematuria(GH) N=44, microscopic hematuria (MH) N=48] were compared to 30 control children with normal renal function and urinalysis who underwent renal doppler sonography for abdominal pain and enuresis from January, 1999 to Febrary, 2000 at Ewha Womans Mokdong Hospital. The narrowed diameter(ND) of the left renal vein between the aorta and superior mesenteric artery and its maximal velocity(NV), and the dilated diameter(DD) of the left renal vein and its maximal velocity(DV) were measured and the DD/ND and NV/DV ratio were compared with those of the control children and the results of several previous reports. RESULTS: The DD/ND ratio was 3.9+/-1.89 in the GH group, 2.4+/-0.62 in the MH group, and 2.0+/-0.48 in the control group. There was a significant difference among GH, MH and control group(p<0.05). The NV/DV ratio was 3.6+/-2.37 in the GH group was significantly higher than 1.9+/-0.60 in the MH group and 1.7+/-0.55 in the control group(p<0.05). There was no significant differences between MH and control groups. Normal cut off values of DD/ND and NV/DV ratio in this study were 3.0 and 2.8 which was different to previous reports. CONCLUSION: Left renal vein entrapment phenomenon should be considered as one of the etiology of asymptomatic non-glomerular hematuria in children and the sonographic diagnostic criteria for Left renal vein entrapment syndrome needs to be revised.