Page kidney: A rare cause of secondary hypertension

Abstract

Page kidney is a rare phenomenon that can present with hypertension. The presence of a subcapsular perirenal collection causes parenchymal compression leading to renal hypoperfusion. Subsequent activation of the renin–angiotensin–aldosterone system results in an increase in systemic blood pressure. The causes of renal subcapsular collections are varied, with most cases being secondary to post-traumatic haematomas. We present the case of a young hypertensive patient, treated as primary hypertension with persistently uncontrolled blood pressures. This was despite good treatment adherence. On further investigation, imaging identified the presence of bilateral subcapsular collections. This case illustrates the importance of a thorough workup in a young hypertensive patient with refractory hypertension. Given that Page kidney is curable, timeous intervention can save the patient from unnecessary medications and the morbidity of uncontrolled blood pressures.

Page kidney after pediatric kidney transplantation: a case report

“…Angiographic evaluation should be considered in cases of recurrent non-traumatic PK (17)(18)(19) . The use of renoscintigraphy with Tc-99m diethylenetriamine penta-acetic acid (DTPA) may serve as a diagnostic and monitoring tool by quantification of baseline and follow-up allograft function measurement, allowing differential diagnosis with other causes of impaired graft function.…”

Bilateral Page kidney in a postpartum female: a case report

“…Nontraumatic or spontaneous causes of Page kidney are uncommon with isolated cases reported in the literature. These include spontaneous renal hemorrhage secondary to underlying tumors, arteriovenous malformations, cyst rupture, glomerulonephritis, antiplatelet therapy, or vasculitis 5 , 6 . In some cases, Page kidney may be idiopathic 4 , 7 .…”

A Rare Case of Intravenously Managed Hypertensive Emergency arising from a Perirenal Hematoma subsequent to a Native Kidney Biopsy

“…It is attributed to extrinsic compression of renal parenchyma by subcapsular hematoma or other sources leading to alteration of small segmental vessel’s hemodynamics. 2 , 3 The etiologies of Page kidney can be traumatic, non-traumatic, or idiopathic. 3 Traumatic etiologies include blunt abdominal injuries or iatrogenic trauma from procedures like renal biopsy, extracorporeal shock wave lithotripsy, and ureteral-laparoscopic procedures.…”

“… 2 , 3 The etiologies of Page kidney can be traumatic, non-traumatic, or idiopathic. 3 Traumatic etiologies include blunt abdominal injuries or iatrogenic trauma from procedures like renal biopsy, extracorporeal shock wave lithotripsy, and ureteral-laparoscopic procedures. 3 Nontraumatic etiologies include spontaneous renal bleeding as a complication of anticoagulation, underlying tumor, cyst rupture, glomerulonephritis, vasculitis, or from arteriovenous malformations.…”

“… 3 Traumatic etiologies include blunt abdominal injuries or iatrogenic trauma from procedures like renal biopsy, extracorporeal shock wave lithotripsy, and ureteral-laparoscopic procedures. 3 Nontraumatic etiologies include spontaneous renal bleeding as a complication of anticoagulation, underlying tumor, cyst rupture, glomerulonephritis, vasculitis, or from arteriovenous malformations. 3 Most reported cases of acute Page Kidney in the literature presented as secondary hypertension requiring treatment of underlying cause and oral antihypertensive agents.…”