Severe Acute Kidney Injury With Significant Uremia in an Infant Found to Have Inferior Vena Cava, Bilateral Renal Vein, and Bilateral Renal Artery Thromboses

Hannah Lively-Endicott; Angelina M. Dixon; Joyce Varghese

doi:10.31486/toj.18.0051

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Figure 1. Patient’s timeline with renal function data.
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Figure 2. Angiography of the (A) inferior vena cava (IVC) (downward arrow) and right renal vein (RV) (leftward arrow) prior to angioplasty. Note the stenosis of the right RV and thrombi visible along the IVC. Angiography of the (B) RV (leftward arrow) shows significant thrombotic occlusion (downward arrow).
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Figure 3. Angiography of the inferior vena cava (IVC) (downward arrow) and right renal vein (RV) (leftward arrow) following angioplasty. Note the slightly improved flow through the right RV (rightward arrow in view A, downward arrow in view B).
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Figure 4. Angiography of the left renal vein (RV) (rightward arrow) shows collateral circulation to the portal system (downward arrows).
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Figure 5. Angiography of the innominate vein (IV) (downward arrow) shows possible stenosis of the left subclavian vein (upward arrow) and collateral circulation to the internal jugular vein (rightward arrow).
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Figure 6. Arteriogram of the abdominal aorta shows that bilateral renal arteries are not patent.
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Figure 7. Arteriogram of the (A) right renal artery (RA) (leftward arrow) and the (B) left RA (rightward arrow) following tissue plasminogen activator administration. Note minimal flow through the right RA.