Renal Vein Thrombosis: Causes, Pathophysiology, Management, Emerging Therapies, and the Role of Artificial Intelligence—A Narrative Review

Elmukhtar Habas¹, Ala Habas², Amnna Rayani³, Aml Habas⁴, Almehdi Errayes⁵

Keywords: Renal vein thrombosis, venous thromboembolism, nephrotic syndrome, direct oralanticoagulants, renal cell carcinoma, artificial intelligence; chronic kidney disease

DOI: 10.63475/yjm.v5i2.0442

DOI URL: https://doi.org/10.63475/yjm.v5i2.0442

Publish Date: 25-08-2026

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Pages: 365 - 372

Citation: 0

Author Affiliation:

1 Professor, Senior Consultant, Hamad Medical Corporation, Hamad General Hospital, Doha, Qatar

2 Medicine Resident, TCH, Open Libyan University, Tripoli, Libya

3 Professor, Senior Consultant, University of Tripoli, Tripoli, Libya

4 Specialist Hematology, Open Libyan University, Tripoli, Libya

5 Senior Consultant, Hamad Medical Corporation, Hamad General Hospital, Doha, Qatar

Abstract

Renal vein thrombosis (RVT) is an uncommon but clinically important condition that arises most often in nephrotic syndrome (NS) and in association with malignancy—particularly renal cell carcinoma with venous tumor extension—inherited or acquired thrombophilias, and, more recently, COVID-19–associated coagulopathy. Because RVT is rare and no randomized trials address it, practice is largely extrapolated from the broader venous thromboembolism (VTE) and chronic kidney disease (CKD) literature. Its pathophysiology follows Virchow’s triad, with hypercoagulability predominating in NS through urinary loss of antithrombin and other regulatory proteins. Anticoagulation remains the cornerstone of treatment: direct oral anticoagulants (DOACs) offer a more favorable benefit–risk profile than vitamin K antagonists in early-stage CKD, whereas evidence in dialysis-dependent patients is insufficient, and management should be individualized to renal function and bleeding risk. Catheter-directed therapy, etiology-directed oncologic treatment, and factor XI inhibitors are promising adjuncts. Artificial intelligence tools for VTE risk prediction, ultrasound diagnosis, and anticoagulation dosing show encouraging performance but remain unvalidated in RVT; disease-specific cohorts and prospective validation are essential before they can be adopted

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