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Nutcracker Phenomenon and Syndrome May Be More Prevalent Than Previously Thought

Nutcracker phenomenon (NCP) occurs when the left renal vein (LRV) is excessively compressed between the abdominal aorta (AA) and the superior mesenteric artery (SMA) [1]. It is called nutcracker syndrome (NCS) when NCP is accompanied by otherwise-unexplainable symptoms or signs, such as hematuria, proteinuria, or left flank pain. NCS is rare, but its exact prevalence remains unknown [2]. NCS is registered as a rare condition on medical websites, such as the Genetic and Rare Diseases Information Center at the National Institutes of Health (NIH-GARD) and Orphanet [2]. This letter alerts readers that this syndrome may be much more common than previously thought. Kim [3] reported, “we may assume that NCS may not be a rare entity, and the prevalence may be higher than previously thought.” patients ultrasound