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Page kidney: case report and review of the literature
T R McCune1, W J Stone, J A Breyer
1Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN 37232-2372.
Insights
Page kidney, a condition caused by bleeding around the kidney, can occur after a renal biopsy. This case highlights its impact on kidney function and hypertension, even in patients with IgA nephropathy.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Radiology
Background:
- Page kidney arises from perinephric or subcapsular space bleeding, leading to kidney compression, ischemia, and hypertension.
- Typically observed in young hypertensive individuals with a history of abdominal or back trauma.
Observation:
- A case of acute Page kidney following a renal biopsy in a patient with IgA nephropathy is presented.
- The patient experienced new-onset hypertension and a significant decline in renal function.
- Diagnostic imaging modalities including MRI, CT, and ultrasound were crucial for diagnosis.
Findings:
- Acute Page kidney can develop post-renal biopsy, complicating underlying kidney disease like IgA nephropathy.
- The compromised contralateral kidney's inability to compensate exacerbates renal dysfunction.
- This condition presents with significant hypertension and decreased glomerular filtration rate.
Implications:
- Highlights a rare but serious complication of renal biopsy.
- Emphasizes the importance of considering Page kidney in the differential diagnosis of acute kidney injury and hypertension post-procedure.
- Reviews therapeutic options and previously reported cases, contributing to clinical understanding and management strategies.
Abstract:
Page kidney is caused by the accumulation of blood in the perinephric or subcapsular space, resulting in compression of the involved kidney, renal ischemia, and high renin hypertension. Most patients are young hypertensives with a remote history of blunt trauma to the abdomen or back. We describe a case of acute Page kidney following a renal biopsy in a patient with underlying IgA nephropathy. In addition to the new-onset hypertension, this patient developed a significant decline in renal function due to the inability of the contralateral diseased kidney to compensate. Magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound were valuable in making this diagnosis. Medical and surgical therapeutic options were considered. This report also reviews all previously described cases of Page kidney.