Page Kidney

Excerpt

Page kidney, or Page phenomenon, results from external compression of the kidney, primarily from subcapsular or perinephric accumulation of blood, and is a rare, treatable cause of secondary hypertension that is mediated by activation of the renin-angiotensin-aldosterone system (RAAS). The RAAS is activated by microvascular ischemia and can lead to severe hypertension and hypertensive complications. The workup of a young patient with hypertension, defined as high blood pressure in a patient younger than 30, should include investigations to rule out secondary causes. Predisposing factors for Page kidney include recent abdominal procedures, a history of abdominal trauma, underlying malignant neoplasm, uncontrolled hypertension, arteriovenous malformations, and cyst rupture. A basic workup for secondary hypertension often includes renal ultrasonography (particularly in patients younger than 30 years), which is usually effective at identifying compressive masses but may miss smaller subcapsular collections.