Woman with lower back pain

Nutcracker syndrome is a vascular compression disorder when two arteries pinch the left renal vein, which carries blood from the left kidney back to the heart. The pinch (compression) can cause blood to flow backward, making veins swell and causing symptoms like pain and bloody urine.

It is a disease related to someone’s anatomy and relationship between blood vessels in the abdomen. This means there is nothing someone can change in their lifestyle to avoid this condition. It can affect children and adults, though it usually doesn't cause symptoms. It is most common in women in their 30s and 40s. Symptoms often appear after rapid weight loss.

At the UM Heart and Vascular Center, our vascular surgeons are experts at diagnosing and treating nutcracker syndrome. To make an appointment with our team or to learn more about our program, call 410-328-5840.


People with nutcracker syndrome usually don't experience any symptoms until they are severe.

Early indicators are blood in the urine, back pain, headaches, bloating, leg swelling and abdominal pain. Some people also experience a backup of urine, making it difficult to pee.


Because these symptoms are common and can be related to other disorders, it can often be difficult to diagnose nutcracker syndrome.

Our imaging specialists have access to advanced technology, allowing us to see exactly what is happening inside your body. Advanced diagnostic procedures we may use includes:

  • Doppler ultrasound: this allows us to see your blood flow in real time
  • CT scan: we take x-ray images from several different angles to build a 3D picture of what is happening inside your body
  • MRI: this allows us to create detailed images of your veins
  • Venogram: this allows us to see your blood vessels from within, and is done as an outpatient appointment in our office


We evaluate each patient to find the best treatment option, knowing each person needs a different approach.

If symptoms are mild, treatment may not be needed and will go away over time.

When symptoms are severe, we may treatment options we may suggest include:

  • Autotransplantation: our multidisciplinary team will aid in moving the kidney from its natural position to one in the pelvis, where there is no chance of compression 
  • Stenting: we will insert a small mesh tube to hold your vein open, preventing backflow of blood. This is a minimally invasive procedure
  • Surgery: our vascular surgery team can reroute your vein, bypassing the section causing pain

Make an Appointment

If you or your loved one has symptoms like these but haven't been able to find a solution, we can help you discover if nutcracker syndrome is the cause. Call 410-328-5840 to learn more about our program or to make an appointment.