Page Kidney - Rare but Correctable Cause of Hypertension

Exploration of Hypertension Following Traumatic Renal Hematoma Formation and Page Kidney Discussion

“…This modality is recommended by the American Association for the Surgery of Trauma to assess renal trauma [ 9 ]. Magnetic resonance imaging (MRI) may also help in assessing the organization and age of the hematoma along with the patency of the vessels it is compressing [ 10 ]. A Doppler ultrasound can also be utilized to aid in identifying the impact of the hematoma on renal blood flow per the renal arterial resistive index value [ 11 ].…”

“…Once identified, the age and organization of the subcapsular hematoma will dictate the most appropriate treatment plan. In objectively mild cases, medical management consisting of angiotensin-converting enzyme inhibitors is trialed first [ 10 ]. Simultaneously, inpatient observation of hematoma absorption is done to determine resolution [ 9 ].…”

“…As these options are minimally invasive and result in decreased rates of morbidity, they are increasingly becoming first-line treatment plans, as exemplified in this case [ 6 ]. In patients presenting with organized or treatment-resistant hematomas, definitive surgery options consist of capsulectomy, partial nephrectomy, or total nephrectomy [ 10 ]. According to the American Urological Association, a large perirenal hematoma (>4 cm) in a hemodynamically unstable patient would require immediate surgical intervention [ 12 ].…”

Page Kidney: A Case of Acute or Chronic Renal Failure & Refractory HTN Presenting after Renal Biopsy

“…If stable, the patient can then be safely transitioned to oral medications. As the hematoma resolves, the hypertension and ARF will also resolve [9].…”