'Page kidney'. Hypertension caused by chronic subcapsular hematoma

Abstract

Conditions analogous to an experimental model of hypertension described by Page in 1939 are called "Page kidney." In chronic subcapsular hematoma, the most common clinical counterpart to Page's model of renal parenchymal compression, a review of the literature reveals that hypertension is usually cured by nephrectomy, but is seldom cured by mere evacuation of the hematoma. To our knowledge, no patient remaining hypertensive after evacuation has undergone nephrectomy. In the patient described herein, a liquified subcapsular hematoma reaccumulated after it was drained percutaneously, and therefore it had to be evacuated surgically. Persistent renin-mediated hypertension, however, prompted curative nephrectomy. The response to more prolonged percutaneous drainage might have guided more effective initial surgery.