Inferior vena cava thrombosis due to polycystic kidney disease

Abstract

Aim: Autosomal dominant polycystic kidney disease is the most common renal hereditary disease. During many years renal cysts become larger, the functional nephron mass decreases and enlarged kidneys compress the surrounding structures. We present the case of a patient with polycystic kidney disease and inferior vena cava thrombosis after kidney transplantation. Case report: Three months after kidney transplantation into the left iliac fossa, the 67 year-old woman was admitted to our hospital due to swelling oft the right leg. Clinical and ultrasound examination revealed deep vein thrombosis of right leg and therapy with heparine was introduced. Since there was no improvement, a computerized tomography examination was performed that confirmed deep vein thrombosis of the right leg, thrombosis of iliac veins on the right side and partial thrombosis of the distal part of the inferior vena cava. As radiologic imaging revealed compression of the right polycystic kidney onto the inferior vena cava, we performed nephrectomy of the polycystic kidney to prevent complete thrombosis. The postoperative course was uneventful, with a regression of the right leg edema and stable graft function. Discussion and conclusion: In patients with large polycystic kidneys, compression of the inferior vena cava may lead to its thrombosis. A nephrectomy should be performed in time.