Page kidney in a hemodialyzed patient

Traumatic page kidney induced hypertension in critical care: immediately resolved or long-term resistant problem

Page kidney is a well-known phenomenon causing hypertension, due to compression of renal parenchyma by a subcapsular hematoma, of either traumatic or non-traumatic origin. The main therapeutic approach is based on surgical approach (nephrectomy or hematoma evacuation) and antihypertensive treatment. In this paper we present a post-traumatic case of Page Kidney in a Critical Care unit. We discuss different therapeutical opportunities to extremely elevated systemic blood pressure resistant to traditional drug therapy.

Page kidney as a rare cause of hypertension: case report and review of the literature

Page kidney occurs by extrinsic compression of the renal parenchyma from a hematoma or a mass, leading to activation of the renin-angiotensin-aldosterone system and resulting in systemic hypertension. There have been about 100 cases of Page phenomenon reported in the literature. A review of cases published prior to 1991 revealed that football and nonsports-related trauma were the most common causes of Page kidney. Thereafter, 28 cases have been reported in the literature, including our case report presented here. These recent cases show that the etiology of Page kidney has shifted, perhaps because of the procedure-oriented current practice of medicine and the increased frequency of kidney transplant biopsies. In addition, management options have evolved, given the more frequent use of medications that block the renin-angiotensin-aldosterone system and the availability of less invasive procedures. Page kidney should be considered in the differential diagnosis of secondary hypertension.

Hypertension in an adolescent boy

We report the case of an adolescent boy who presented with hypertension and hypokalemia. A systematic work-up revealed hyperreninemic hyperaldosteronism. Further study revealed Page kidney caused by trauma-associated renal hematoma. The evaluation and management of hyperaldosteronism and Page kidney are discussed.