Clinical Analysis Of Nutcracker Syndrome Complicated With Kidney Disease

Objective To investigate the clinical characteristics, diagnosis and treatment of nutcracker syndrome (NCS) in children complicated with kidney diseases.Methods Retrospective survey was performed in 78 cases of nutcracker syndrome complicated with kidney diseases((mixed group) and 79 cases of nutcracker syndrome(single group) from Jan.2009 to Dec. 2013.Their clinical manifestations, auxiliary examinations and therapies were analyzed.Results The ratio of male to female is 87:70,and the ages rang from 4 to 15 years old. Age of two groups were not significantly different.The percentage of boys in mixed group was higher than that in single group. In mixed group boys were more common,gross hematuria and.proteinuria were easier found.Higher BUN [(5.00±2.11) mmol/L vs (4.11±1.15) mmol/L, P=0.015],more severe hematuria[125(22.4-946) (myriad/12h) vs 45 (0.56-368) (myriad/12h), P=0.009] and proteinuria[0.19(0.08-0.57)g/d vs 0.06(0.02-0.15)g/d, P=0.001] were found in mixed group.Differences of ultrasonography and CTA in two groups were not significant. By follow-up of these patients,there were 19 cases without clinical manifestations and one case with gross hematuria after getting a cold in mixed group.In single group, there were 19 cases without clinical manifestations and one case with gross hematuria after getting a cold.Conclusions Hematuria is the most common manifestation of NCS.The prognosis of NCS is good in most cases.NCS may coexist with kidney diseases. Kidney diseases should be considered in cases of nutcracker syndrome with gross hematuria, severe proteinuria and higher BUN. Renal biopsy shall be carried out if it is necessary.