The majority of patients with Nutcracker syndrome present with hematuria with/without low back pain. Most patients are long, lean adolescents with clinical manifestations of upright proteinuria and left sided varicocele in men are also common. Some middle-aged and older women patients may present with hematuria and pelvic stasis syndrome. The diagnosis of nutcracker syndrome is exclusionary, that is, typical clinical symptoms and ancillary tests can prove the presence of “nutcracker” structures, while excluding other possible causes of clinical symptoms (such as tumors, stones, infections, malformations and glomerular diseases). The most accepted diagnostic indicators are: 1, urinary red blood cell morphology of non-glomerular origin (i.e., the proportion of normal red blood cell morphology in urine > 90%). 2, Urinary calcium excretion ratio is normal (Ca/Cr<0,20). 3, Cystoscopy for left ureteral spurting (during an episode of sarcoid hematuria). 4, Normal renal biopsy or minor lesions. 5, Abdominal ultrasound, CT and MRI showed compression and dilatation of the left renal vein. 6, Inferior vena cava and left renal vein manometry confirmed left renal reflux obstruction, and the pressure difference between left renal vein pressure and inferior vena cava was above 4 mmhg (pressure difference of 5 mmHg was also reported). 7. Exclude other possible causes of hematuria. The "gold standard" for the diagnosis of NCS is left renal venography, and the diagnosis can be confirmed by measuring the pressure difference between its distal end and the inferior vena cava >0.49kpa. However, angiography is an invasive test, compared to ultrasound, which is convenient and easy to perform and should be the most commonly used test. Doppler ultrasound examination in supine, upright, left lateral, and right lateral positions can confirm the diagnosis by dilating the inner diameter of the compressed left renal vein more than 3 times.