J Korean Soc Pediatr Nephrol.  2006 Oct;10(2):213-218.

Spontaneous Resolution of Childhood Nutcracker Syndrome

Affiliations
  • 1Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea. jsyonse@yumc.yonsei.ac.kr

Abstract

PURPOSE
Nutcracker syndrome refers to compression of the left renal vein(LRV) between the aorta and superior mesenteric artery(SMA) that results in elevation of pressure in the LRV and development of collateral veins. It must be considered as a possible factor when hematuria or proteinuria occurs in a healthy child. The purpose of this study is to determine the time to spontaneous resolution in childhood nutcracker syndrome, and to observe whether this is affected by sex, age, proteinuria or initial ratio of peak velocity of LRV.
METHODS
We investigated 26 patients who were found to have spontaneous resolution by follow-up Doppler ultrasonography among 117 patients diagnosed with nutcracker syndrome by renal Doppler ultrasonography from May 2001 to December 2005. We determined the time to spontaneous resolution in childhood nutcracker syndrome, and observed whether the duration was affected by sex, age, proteinuria or initial ratio of peak velocity.
RESULTS
26 patients(59%) achieved spontaneous resolution by 1.2 years(mean). The time to spontaneous resolution of childhood nutcracker syndrome in 26 patients was 16.71+/-9.99 months(range 6.0-49.2). The time to spontaneous resolution was not affected by sex, age, proteinuria nor initial ratio of peak velocity of LRV.
CONCLUSION
More than half of the patients who were diagnosed by renal Doppler ultrasonography achieved spontaneous resolution. The time to spontaneous resolution was not affected by sex, age, proteinuria nor initial ratio of peak velocity of LRV.

Keyword

Nutcracker syndrome; Resolution; Peak velocity

MeSH Terms

Aorta
Child
Follow-Up Studies
Hematuria
Humans
Proteinuria
Ultrasonography, Doppler
Veins
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