Page Kidney from a Subcapsular Urinoma

Case Report

Austin J Clin Case Rep. 2020; 7(4): 1179.

Page Kidney from a Subcapsular Urinoma

Izekor B1*, Odigwe C2 and Duran P2

1Department of Internal Medicine, Baylor Scott & White Medical Center- Temple, USA

2Division of Nephrology, Baylor Scott & White Medical Center- Temple, USA

*Corresponding author: Izekor B, Department of Internal Medicine, Baylor Scott & White Health, USA

Received: October 20, 2020; Accepted: November 10, 2020; Published: November 17, 2020


Urinomas, though rare, are an important cause of Page kidney and acute kidney injury. Urinoma should be suspected and evaluated for in patients with AKI who are high risk for Page kidney, whether they are hypertensive or not.


AKI: Acute Kidney Injury; IVC: Inferior Vena Cava; ECSWL: Extra Corporeal Shockwave Lithotripsy; KDIGO: Kidney Disease; Improving Global Outcomes


Page kidney or Page phenomenon is the extrinsic compression of the kidneys by a mass. It is a rare cause of kidney injury and hypertension; as of 2009 there were 128 cases reported [1]. The most common reported cause of Page kidney is hematoma and is often associated with trauma or renal instrumentation such as biopsies. Other causes include lymphatic cysts, tumors and urinomas. Urinomas are very rare causes of Page kidney. From our review, there were only four reported cases as of 2009, none of which were associated with acute kidney injury.

We report here a case of Page kidney and acute kidney injury due to right kidney compression by a subcapsular urinoma in a patient with a solitary kidney. His pathology was complicated by ureteral obstruction; the patient initially required renal replacement therapy. Renal function dramatically improved following percutaneous drainage of urinoma warranting discontinuation of renal replacement therapy.

Case Presentation

A man in his mid-70s was diagnosed with metastatic renal cell carcinoma affecting his left kidney. Preliminary studies showed the tumor had invaded his left renal vein to as far as his IVC. He was sent to our facility for a radical left nephrectomy. His surgery was complicated by difficult tumor resection and blood loss of 3.5 L. Bilateral renal veins were dissected along with the IVC; surgery last 2 hrs longer than anticipated. Patient was anuric postop, his creatinine also rose to 2.8 from a baseline of 1.5. Nephrology was consulted, initial impression was that his anuria was due to AKI from renal hypoperfusion secondary to blood loss and perioperative hypotension. He was placed on hemodialysis as his anuria never resolved. Of note, renal ultrasound done during this hospitalization showed very mild hydronephrosis of his right kidney, not enough to account for his AKI.

Citation: Izekor B, Odigwe C and Duran P. Page Kidney from a Subcapsular Urinoma. Austin J Clin Case Rep. 2020; 7(4): 1179.