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Living with Renal nutcracker syndrome

A condition in which the vein from the left kidney is squeezed, sometimes causing blood in the urine and flank pain.

Understanding Renal nutcracker syndrome

Renal nutcracker syndrome occurs when the left renal vein, which carries blood from the left kidney, becomes compressed.

Some people have no symptoms, while others have severe and ongoing ones. In children, mild cases may be due to changes in body proportions with growth. GARD says it is less clear why it occurs or causes symptoms in adults. GARD lists onset in adulthood.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Blood in the urine (hematuria)
  • Flank pain
  • Low back pain
  • Abdominal pain
  • Protein in the urine when standing (orthostatic proteinuria)
  • Varicose veins or varicocele

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include genetic specialists and kidney specialists.

  3. Ask which tests can help

    Your care team will decide which exams and tests can confirm the diagnosis.

Care & treatment

Care team
Genetic specialists (geneticists); Kidney specialists (nephrologists)
Expert care
Ask about multidisciplinary care centers for rare conditions
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with National Kidney Foundation and other patient organizations
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Which tests confirm compression of the left renal vein?
Does my mild case need treatment, or only monitoring?
Which specialists should follow my care?

Quick facts

Symptoms usually startAdult

The left renal vein becomes compressed. GARD says it is less clear why this occurs or causes symptoms in adults, and that in children it may relate to changes in body proportions with growth.

GeneticKidney

Also known as: left renal vein (lrv) entrapment syndrome; left renal vein entrapment syndrome; mesoaortic compression of left renal vein; ncs - nutcracker syndrome; rns

Patient organizations

Source: NIH GARD · Renal nutcracker syndromeGARD ID 11971 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Renal nutcracker syndrome.

Explore the Renal nutcracker syndrome blog

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