| Page kidney | |
|---|---|
| Other names | Page phenomena |
| Specialty | Nephrology, hypertension |
| Symptoms | Hypertension, |
| Complications | Persistent hypertension, renal failure, loss of renal allograft |
| Causes | Trauma, hematomas, masses, iatrogenic (post-procedural, post-surgical) |
| Risk factors | Renal biopsies and other medical procedures, contact sports, motor vehicle collisions |
| Diagnostic method | Imaging (ultrasound, CT) |
| Treatment | Medical or surgical |
| Medication | Antihypertensives [angiotensin-converting enzyme inhibitor (ACEi), angiotensin receptor blockers (ARB)] |
Page kidney or Page phenomena is a potentially reversible form of secondary arterial hypertension caused by external compression of the renal parenchyma by some perirenal process.[1] Any process that causes mass effect can be a potential cause of Page kidney. Hematomas, urinomas, tumors, cysts, lymphoceles, and aneurysms have all been reported in the literature.[2] The compression is believed to cause activation of the renin–angiotensin–aldosterone system (RAAS) via microvascular ischemia.[citation needed]
Initially, the majority of cases that were described had a traumatic etiology but this has since shifted to iatrogenic causes.[3] Since Page kidney is primarily a unilateral process, symptoms will differ depending on if the patient has native kidneys or not.[2] In patients with only one solitary functioning kidney, the acute hypertension will also be accompanied by an acute decrease in renal function.
In patients with one functioning kidney, prompt diagnosis and surgical treatment are needed to prevent irreversible kidney damage and restoration of kidney function. Medical treatment involves use of an angiotensin-converting enzyme inhibitor (ACEi) or an angiotensin receptor blocker (ARB) to control the hypertension.[3]