Intravenous infusion of contrast material assists in visualizing the renal veins. MRI produces high contrast images between flowing blood, vascular walls and surrounding tissue. The major benefit is the avoidance of radiation and IV contrast material. May also detect renal vein thrombosis. Renal histologic features of nephrotic patients with renal vein thrombosis are representative of the responsible primary renal disease.
Membranous nephropathy is the most common finding.
Measures may include steroids and immune-suppression. Anticoagulation with warfarin has been recommended in some studies for prophylaxis against pulmonary embolism. Hypercholesterolemia should be treated. Surgery had been used when bilateral RVT is present, or if pulmonary emboli have occurred and anticoagulation is contraindicated. Inferior vena caval filters may be used in this instance.