Page Kidney

Excerpt

Page kidney or Page phenomenon results from external compression of the kidney and is a rare, treatable cause of secondary hypertension that is mediated by activation of the renin-angiotensin-aldosterone system (RAAS). The workup of a young patient with hypertension, defined as high blood pressure below the age of 30, is comprised of extensive investigations to rule out a secondary cause. However, a sharp rise in the prevalence of hypertension in the young has been observed, doubling over the last decade, and most often a diagnosis of essential/primary hypertension is made. As there is an ever-rising burden on healthcare costs, it is recommended in the guidance that the routine workup of such patients is limited to a basic set of investigations. Specialized investigations, such as renal imaging, should only be kept for cases where there is a clinical suspicion of underlying secondary pathology. In most places, renal ultrasound is still included in the baseline investigations; however, sometimes it is sparingly available. Therefore young patients are frequently diagnosed with essential/primary hypertension causing a delay in the diagnosis of secondary hypertension.