Resources for Individuals with Nutcracker Syndrome
Nutcracker Syndrome is a rare vascular condition that occurs when the left renal vein is compressed between the abdominal aorta and the superior mesenteric artery.
If you have been diagnosed with Nutcracker Syndrome and your doctors have recommended removing the affected kidney as the best treatment option, you may be able to donate your kidney to someone in need of a kidney transplant.
Ready to see if you’re qualified to donate your kidney?
Take the first step and complete a 5-minute introductory questionnaire.
LJ Dong: My Nutcracker Syndrome Kidney Donation Story
When LJ Dong was diagnosed with Nutcracker Syndrome and the first surgery to repair it did not work, her two option were redoing the surgery or having a nephrectomy to remove the kidney. The kidney itself was healthy, but the vein leading to it was not. So, she thought, If I have to take the kidney out, how can I give it to someone? Read LJ’s donation story.
Nutcracker Syndrome FAQ
Nutcracker Syndrome is a condition that occurs when the left renal vein is compressed between the aorta and the superior mesenteric artery, leading to symptoms like flank pain, hematuria (blood in urine), and pelvic congestion.
The name comes from how the left renal vein is squeezed, like a nut in a nutcracker. This compression usually happens between the abdominal aorta (a large artery) and the superior mesenteric artery.
Nutcracker Syndrome can be caused by:
The natural anatomy of some people, where the angle between the arteries is too small
Weight loss, which can reduce fat cushioning around the blood vessels
Other conditions that put pressure on the blood vessels
Common symptoms of Nutcracker Syndrome include:
Flank or abdominal pain
Blood in the urine (hematuria)
Pelvic pain or varicose veins in the lower abdomen
Fatigue and orthostatic intolerance
Protein in the urine (proteinuria)
Diagnosis typically involves imaging studies such as ultrasound, CT angiography, MRI, or venography to confirm vein compression, as well as urinalysis to look for signs of hematuria or proteinuria.
Treatment varies based on severity and may include:
LRV transposition: A surgical procedure that relocates the left renal vein to a lower position on the inferior vena cava (a large vein that carries blood to the heart)
LRV stenting: In severe cases, doctors may place a stent in the vein, which expands the vein to allow for proper blood flow to the heart.
Transplantation: In severe cases, patients may be given two transplant options to treat their symptoms:
Auto-transplantation, where the nutcracker kidney is surgically removed from the patient and then transplanted back into the patient in the pelvis, near the bladder.
Therapeutic nephrectomy, where the patient elects to undergo a nephrectomy and chooses to donate the kidney to a patient with end-stage renal disease.
In some cases, prolonged venous compression can lead to kidney congestion, protein loss, or even kidney dysfunction, but most patients do not experience significant kidney failure.
It depends on individual health status and kidney function. Some Nutcracker Syndrome patients may be ineligible due to vascular abnormalities or concerns about kidney resilience after donation, but many individuals with Nutcracker Syndrome may be eligible to donate a kidney. A transplant team will evaluate each case carefully.
Speak to your transplant team about the possibility of becoming a living kidney donor. You can also register with the National Kidney Registry to start the donation process and see if you qualify. The National Kidney Registry can also provide more information and help you find a center that provides education, treatment options, and specialized care for Nutcracker Syndrome patients.
