Presentation
Bilateral flank pain, bilateral lower limb edema.
Patient Data
Both kidneys appear swollen with surrounding perirenal fat stranding and free fluid, more on the right side, without detectable stones or hydronephrosis. By correlation with lab results, features suggest nephrotic syndrome.
A mild amount of abdominopelvic free fluid is noted.
Our patient's labs show:
Protein in spot urine: 993 mg/dL.
Creatinine in spot urine: 115 mg/dL.
Pro/Crea ratio: 8.6
The previous lab results indicate proteinuria; further investigation by kidney biopsy proved nephrotic syndrome.
Case Discussion
Nephrotic syndrome is one of the best-known presentations of adult or pediatric kidney disease. The term describes the association of heavy proteinuria with peripheral edema, hypoalbuminemia, and hypercholesterolemia.
Thromboembolism is a complication of nephrotic syndrome. Pulmonary embolism, renal vein thrombosis, and deep vein thrombosis are the most common venous thromboembolic diseases in patients with nephrotic syndrome.
Radiological imaging plays an important role in the detection and follow-up of thromboembolism in these patients.
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