Macroscopic hematuria, what can it hide?

The nutcracker syndrome is caused characterized by extrinsic compression of the left renal vein, which prevents its normal blood drainage in the inferior vein cava. In the majority of cases, compression of the left renal vein occurs between the aorta and the superior mesenteric artery, being called the anterior nutcracker syndrome. Less frequently, the left renal vein is in a retroaortic position, resulting in compression between the aorta and the vertebral body, which is called posterior nutcracker syndrome. The characteristic feature is microscopic hematuria or more often macroscopic, especially after being in a standing position or after physical exercise. Orthostatic proteinuria or the combination of hematuria and proteinuria, abdominal pain and left varicocele may be other manifestations of the syndrome.