Arterial Hypertension due to Perirenal and Subcapsular Hematoma Induced by Renal Percutaneous Biopsy

Post-Renal Biopsy Acute Kidney Injury and Page Kidney from Intra-Renal Hematoma Aggravated by Reversible Contrast-Induced Nephropathy Following Renal Arterial Embolization

Patient: Male, 73-year-old

Final Diagnosis: Page kidney from intra-renal hematoma aggravated by reversible contrast-induced nephropathy following renal arterial embolization

Symptoms: Flank pain • nausea • vomiting

Medication: Apixaban

Clinical Procedure: Kidney biopsy and subsequent renal arterial embolization

Specialty: Nephrology

Page kidney secondary to subcapsular hematoma following percutaneous renal allograft biopsy

Percutaneous renal biopsy with ultrasound guidance is a helpful procedure regularly performed to obtain renal tissue diagnosis for rejection in the postrenal transplant setting; however, it is not without risks. We report the case of a 42-year-old male with end stage renal disease who developed a subcapsular hematoma, with subsequent hypertension and renal failure, compatible with acute page kidney as a complication of the renal biopsy. The ultrasound images demonstrated classic imaging appearances which all diagnostic and interventional radiologists should be aware of. The patient was managed successfully with conventional open surgical evacuation of the hematoma with return to baseline laboratories and vital signs after the procedure.

Successful non-surgical treatment of perirenal haematoma after percutaneous renal artery angioplasty in a solitary kidney

Renal artery angioplasty with stent placement represents an effective choice for correcting renal artery stenosis. However, if iatrogenic renal artery injury occurs, as in the case of solitary kidney, the risk of requiring chronic dialysis increases. This article reports the case of a patient with a solitary kidney, who underwent renal stenting and developed a retroperitoneal haematoma. The patient was managed conservatively and the perirenal haematoma resolved. Within the period of follow-up, the patient had maintained stable renal function with adequate blood pressure control.

Page kidney after renal allograft biopsy: sonographic findings

The development of renal failure and hypertension due to extrinsic renal compression by hematoma in the subcapsular space is well-described and most commonly seen after blunt trauma. It may also occur as a complication of percutaneous renal biopsy, both in native kidneys and renal allografts, and is a rare cause of reversible allograft failure. We describe a case of Page kidney in renal transplantation after percutaneous biopsy causing allograft dysfunction. Early recognition with sonography is important if irreversible damage to the allograft is to be prevented.

Prolonged fever following kidney biopsy: a case report

This case report describes a patient with prolonged fever following a kidney biopsy. Workup disclosed a large perirenal and retroperitoneal hematoma. Neither imaging nor blood cultures supported an infective cause of his fever. Although the patient was initially treated with antibiotics, fever eventually resolved spontaneously. A review of the literature is provided addressing the association of fever with resorption of hematoma. Fever should be added to the list of potential complications of kidney biopsy. A conservative management is advocated.

Subcapsular Hematoma Evacuation as a Method of Evaluating Injured Kidneys for Transplant

Background

Approximately one-third of organ donors in the United States are trauma victims. In general, kidneys with large subcapsular hematomas are not used for transplant because of the possibility of significant parenchymal injury. A large subcapsular renal hematoma may cause scarring resulting in renal parenchymal compression and development of the Page syndrome.

Objective

To elucidate a successful method of evaluating kidneys subject to trauma, while also possibly preventing further damage and improving their function.

Design

Data were collected from the donor kidney pool of the New York Organ Donor Network from January 2006 through July 2007. Four kidneys during that period were determined to have significant subcapsular hematomas. Surgical intervention was undertaken and outcomes after transplantation were reviewed.

Main Outcome Measures

Four of the kidneys underwent a surgical procedure to drain the subcapsular hematoma allowing assessment of the underlying renal parenchyma. All 4 of these kidneys were deemed transplantable. After transplantation, 3 of the 4 kidneys had immediate function and did not require dialysis. The remaining kidney was removed as a result of primary nonfunction.

Conclusion

The described surgical intervention allows the transplant surgeon to accurately assess the extent of damage to a traumatized kidney while possibly preventing further damage to the kidney.

Spontaneous perirenal hematoma with AA amyloidosis in a hemodialysis patient after unilateral nephrectomy

Secondary amyloidosis presents with a variety of systemic symptoms or signs. Amyloid diseases can be associated with potentially life-threatening hemorrhage. Although bleeding manifestations are common in amyloidosis, renal bleeding is rare and generally due to trauma, cyst and malignancy. For the first time we present a ureamic patient who was diagnosed with AA amyloidosis after unilateral nephrectomy because of spontaneous perirenal hematoma.