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Trombosis de la vena renal

Definición

Es un coágulo de sangre que se desarrolla en la vena que drena sangre del riñón.

Causas

La trombosis de la vena renal es un trastorno poco común que puede ser causado por:

• Aneurisma aórtico abdominal
• Estado de hipercoagulación -- trastornos de la coagulación
• Deshidratación (sobre todo en bebés)
• Uso de estrógenos
• Síndrome nefrótico
• Embarazo
• Formación de cicatriz con presión sobre la vena renal
• Traumatismo (a la espalda o al abdomen)
• Tumor

En los adultos, la causa más común es el síndrome nefrótico, mientras que en los bebés es la deshidratación.

Síntomas

Los síntomas pueden incluir:

• Coágulo de sangre al pulmón
• Sangre en la orina
• Disminución del gasto urinario
• Dolor de costado o lumbago

Pruebas y exámenes

Es posible que un examen no revele el problema específico; sin embargo, puede indicar síndrome nefrótico u otras causas de trombosis de la vena renal.

Los exámenes incluyen:

• Tomografía computarizada del abdomen
• Resonancia magnética abdominal
• Ultrasonido abdominal
• Examen Doppler dúplex de las venas del riñón
• Un análisis de orina puede mostrar proteína en la orina o glóbulos rojos sanguíneos en la orina
• Radiografía de las venas renales (venografía)

Tratamiento

El tratamiento ayuda a prevenir la formación de nuevos coágulos de sangre y reduce el riesgo de que estos coágulos se muevan a otros lugares del cuerpo (embolia).

Usted puede recibir medicamentos que impidan la formación de coágulos de sangre (anticoagulantes). Le pueden recomendar reposo en cama o reducir la actividad durante un tiempo corto.

Si se presenta insuficiencia renal aguda, se puede necesitar diálisis por un período breve.

Expectativas (pronóstico)

Generalmente, la trombosis de la vena renal mejora con el tiempo sin que se presente daño permanente en los riñones.

Posibles complicaciones

Las complicaciones pueden incluir:

• Insuficiencia renal aguda (especialmente si la trombosis se presenta en un niño deshidratado).
• Enfermedad renal terminal.
• Coágulo de sangre que se desplaza hacia los pulmones (embolia pulmonar).
• Formación de nuevos coágulos de sangre.

Cuándo contactar a un profesional médico

Contacte a su proveedor de atención médica si tiene síntomas de trombosis de la vena renal.

Si ha experimentado trombosis de la vena renal, llame a su proveedor si presenta:

• Disminución del gasto urinario
• Sangre en la orina
• Problemas respiratorios (debido a un coágulo sanguíneo moviéndose hacia el pulmón llamado embolia pulmonar)
• Otros síntomas nuevos

Prevención

En la mayoría de los casos, no existe una forma específica de prevenir la trombosis de la vena renal. Mantener el cuerpo suficientemente hidratado puede ayudar a reducir el riesgo.

El ácido acetilsalicílico (aspirin) se usa algunas veces para prevenir la trombosis de la vena renal en personas que se hayan sometido a un trasplante de riñón. Se pueden recomendar anticoagulantes como la warfarina en algunas personas con enfermedad renal crónica.

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