Diagnosis and treatment in children with Nutcracker Syndrome: Single-center experience

Objective: It has been aimed to report the experience of our center regarding diagnosis and treatment experience in children with Nutcracker syndrome (NCS). Materials and Methods: The medical records of the seven patients who have admitted to the Department of Pediatric Nephrology of our hospital between February 2017 and March 2020 were evaluated retrospectively. The diagnosis of NCS was confirmed with renal Doppler ultrasound (RDUS) and magnetic resonance angiography (MRA) in these patients who have admitted with the complaints of hematuria and proteinuria. The patient data such as clinical characteristics, radiological findings, radiological signs and information about the applied medical treatment at baseline and the last control examination were recorded. Results: The mean levels of 24-h urine protein excretion in all the patients at baseline and the last control examination were 15,25±9,19 mg/m2/h and 9,8±3,94 mg/m2/h, respectively. The mean levels of 24-h urine protein excretion in the patients treated with ACE (angiotensin converting enzyme) inhibitor at baseline and the last control examination were 20±11,53 mg/m2/h and 9,6±6,44 mg/m2/h, respectively. (p=0,073). The mean levels of 24-h urine protein excretion were 11.7±6.39 mg/m2/h and 9.95±1.84 mg/m2/h in the patients not receiving ACE inhibitor treatment, at baseline and the last control examination respectively (p= 0,61). The mean angle value of the left renal vein in the aortomesenteric distance measured by RDUS examination performed in the upright position was 14,71±4,46 degrees. The anteroposterior diameter of the left renal vein (hilar/aortomesenteric) measured in the upright position was 6,4. Conclusion: The benign nature of NCS in young patients requires maintaining conservative approach.