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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Page kidney: etiology, renal function outcomes and risk for future hypertension

Andrew Smyth1, C Scott Collins, Bjorg Thorsteinsdottir

  • 1Department of Nephrology, Galway University Hospitals, Galway, Ireland.

Journal of Clinical Hypertension (Greenwich, Conn.)
|March 31, 2012
PubMed

Insights

Page kidney, a cause of hypertension from renal hematoma, presents differently in trauma versus nontrauma cases. Trauma patients are typically younger with less severe kidney issues, while nontrauma cases require more medication and higher nephrectomy rates.

Area of Science:

  • Nephrology
  • Hypertension Research
  • Trauma Surgery

Background:

  • Page kidney, initially linked to traumatic renal subcapsular hematomas causing renin-mediated hypertension, also arises from nontraumatic etiologies.
  • Understanding the differences between traumatic and nontraumatic Page kidney is crucial for effective management.

Observation:

  • A review of 26 Page kidney cases (1960-2010) identified distinct characteristics between trauma (9 patients) and nontrauma (17 patients) groups.
  • Trauma patients were younger, presented with lower systolic blood pressure and higher baseline estimated glomerular filtration rate (eGFR).
  • No significant differences were observed in presenting symptoms, imaging, urinalysis, or pathology between the groups.

Findings:

  • Nontrauma Page kidney cases necessitated more antihypertensive medications and had higher rates of nephrectomy.
  • While eGFR improved in all patients post-treatment, the improvement was more pronounced in the trauma group.
  • New-onset hypertension was observed irrespective of the Page kidney's etiology.

Implications:

  • The study highlights two distinct patient profiles for Page kidney, informing diagnostic and treatment strategies.
  • Close blood pressure monitoring is essential for all patients with new-onset hypertension, regardless of Page kidney cause.
  • Further research into the long-term outcomes and specific management pathways for traumatic versus nontraumatic Page kidney is warranted.

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