Thursday, October 21, 2010

CONSULT ROUNDS: Page Kidney

What is a page kidney?
Page kidney is the external compression of a kidney. The condition is usually caused by a subcapsular haematoma, associated with high blood pressure and occasional renal injury, as described by Irwin Page in an animal model with cellophane papers wrapped round the kidney in 1939 and, subsequently, clinically in 1955. Its not from external abdominal compression like seen in abdominal compartment syndrome. Its rather a bleed within the confines of the kidney that can cause compression of renal vasculature and ultimately HTN and renal injury.
What do you do? Previously, the treatment of Page kidney has been exclusively surgical, but recently, laparoscopy- and radiology-assisted drainage has been used successfully. Management of hypertension is tough and sometimes requires nephrectomy as well.


Few good references:
http://www.nejm.org/doi/full/10.1056/NEJMicm020037
http://www.ncbi.nlm.nih.gov/pubmed/20694451
http://www.ncbi.nlm.nih.gov/pubmed/20535256

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