{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:49:05Z","timestamp":1790848145688,"version":"4.1.0"},"reference-count":59,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Nutcracker syndrome (NCS) refers to symptomatic compression of the left renal vein (LRV), most commonly between the aorta and superior mesenteric artery (anterior nutcracker) or, less frequently, between the aorta and vertebral column in the presence of a retro-aortic LRV (posterior nutcracker). This venous entrapment elevates renal venous pressure and promotes drainage through the gonadal and pelvic venous networks. Clinical manifestations typically include haematuria, left flank or abdominal pain, orthostatic proteinuria, and features of gonadal or pelvic venous congestion such as varicocele. Diagnosis relies on careful clinical evaluation, exclusion of alternative aetiologies, and targeted imaging modalities including Doppler ultrasonography, computed tomography, magnetic resonance angiography, venography, and intravascular ultrasound. Despite increasing recognition of NCS, standardized diagnostic criteria and imaging thresholds remain lacking. Management strategies range from conservative treatment to endovascular interventions and open or laparoscopic surgical procedures. Optimal care requires a multidisciplinary approach involving urology, radiology, nephrology, and vascular surgery to ensure accurate diagnosis and individualized treatment planning.<\/jats:p>","DOI":"10.1093\/ckj\/sfag124","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T11:48:33Z","timestamp":1776858513000},"source":"Crossref","is-referenced-by-count":3,"title":["Nutcracker syndrome in 2026: a nephrologist-oriented diagnosis and management"],"prefix":"10.1093","volume":"19","author":[{"given":"Ernesta","family":"Ma\u010dionien\u0117","sequence":"first","affiliation":[{"name":"Center of Nephrology, Vilnius Universty Hospital Santaros Klinikos , Vilnius ,","place":["Lithuania"]},{"name":"Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University , Vilnius ,","place":["Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agn\u0117","family":"Kerpauskien\u0117","sequence":"additional","affiliation":[{"name":"Center of Nephrology, Vilnius Universty Hospital Santaros Klinikos , Vilnius ,","place":["Lithuania"]},{"name":"Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University , Vilnius ,","place":["Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urt\u0117","family":"\u017dakauskien\u0117","sequence":"additional","affiliation":[{"name":"Center of Nephrology, Vilnius Universty Hospital Santaros Klinikos , Vilnius ,","place":["Lithuania"]},{"name":"Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University , Vilnius ,","place":["Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Vitkauskait\u0117","sequence":"additional","affiliation":[{"name":"Center of Nephrology, Vilnius Universty Hospital Santaros Klinikos , Vilnius ,","place":["Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rokas","family":"Gir\u010dius","sequence":"additional","affiliation":[{"name":"Vilnius University Hospital Santaros Klinikos, Center of Radiology and Nuclear Medicine , Vilnius ,","place":["Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Miglinas","sequence":"additional","affiliation":[{"name":"Center of Nephrology, Vilnius Universty Hospital Santaros Klinikos , Vilnius ,","place":["Lithuania"]},{"name":"Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University , Vilnius ,","place":["Lithuania"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"2026050905164617100_bib1","doi-asserted-by":"publisher","first-page":"2015","DOI":"10.1093\/ndt\/gfi078","article-title":"Nutcracker phenomenon or nutcracker syndrome?","volume":"20","author":"Shin","year":"2005","journal-title":"Nephrol Dial Transplant"},{"key":"2026050905164617100_bib2","doi-asserted-by":"publisher","first-page":"552","DOI":"10.4065\/mcp.2009.0586","article-title":"Nutcracker phenomenon and nutcracker syndrome","volume":"85","author":"Kurklinsky","year":"2010","journal-title":"Mayo Clin Proc"},{"key":"2026050905164617100_bib3","volume-title":"Anonymous Method of Anatomy. 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