Warnich Ilonka, Nicolaou Mark, Sofianos Zelia, Pienaar Jacobus A, Varghese Jacob
Department of Diagnostic Radiology, University of the Witwatersrand, Johannesburg, South Africa.
Department of Diagnostic Radiology, Klerksdorp/Tshepong Hospital Complex, Klerksdorp, South Africa.
SA J Radiol. 2019 Sep 23;23(1):1762. doi: 10.4102/sajr.v23i1.1762. eCollection 2019.
Page kidney is a rare phenomenon that can present with hypertension. The presence of a subcapsular perirenal collection causes parenchymal compression leading to renal hypoperfusion. Subsequent activation of the renin-angiotensin-aldosterone system results in an increase in systemic blood pressure. The causes of renal subcapsular collections are varied, with most cases being secondary to post-traumatic haematomas. We present the case of a young hypertensive patient, treated as primary hypertension with persistently uncontrolled blood pressures. This was despite good treatment adherence. On further investigation, imaging identified the presence of bilateral subcapsular collections. This case illustrates the importance of a thorough workup in a young hypertensive patient with refractory hypertension. Given that Page kidney is curable, timeous intervention can save the patient from unnecessary medications and the morbidity of uncontrolled blood pressures.
佩奇肾是一种罕见的现象，可伴有高血压。肾周包膜下积液的存在会导致实质受压，进而引起肾灌注不足。随后肾素-血管紧张素-醛固酮系统的激活会导致全身血压升高。肾包膜下积液的病因多种多样，大多数病例继发于创伤后血肿。我们报告一例年轻高血压患者的病例，该患者被当作原发性高血压治疗，但血压持续控制不佳。尽管患者对治疗依从性良好，但仍出现这种情况。进一步检查时，影像学检查发现双侧包膜下积液。该病例说明了对难治性高血压的年轻患者进行全面检查的重要性。鉴于佩奇肾是可治愈的，及时干预可使患者避免不必要的药物治疗以及血压控制不佳带来的不良影响。
