ICD-10: N26.2

Page kidney, classified under ICD-10 code N26.2, refers to a condition characterized by renal impairment due to external compression of the kidney, typically caused by a hematoma or a mass. This condition can lead to significant clinical manifestations and requires careful evaluation for diagnosis and management. Below is a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with Page kidney.

Clinical Presentation

Definition and Etiology

Page kidney occurs when a hematoma or other mass compresses the kidney, leading to renal ischemia and potential renal dysfunction. This condition is often associated with trauma, but it can also arise from other causes such as tumors or cysts that exert pressure on the renal tissue[1][2].

Common Causes

• Trauma: Blunt or penetrating injuries to the abdomen can lead to hematoma formation around the kidney.
• Surgical Complications: Postoperative hematomas or abscesses can compress the kidney.
• Tumors: Renal or perirenal tumors can cause external compression.
• Cysts: Large renal cysts may also lead to similar compressive effects.

Signs and Symptoms

Clinical Signs

Patients with Page kidney may exhibit a range of signs, which can vary based on the severity of the condition and the underlying cause:
- Hypertension: Often, patients present with secondary hypertension due to renal ischemia and activation of the renin-angiotensin-aldosterone system (RAAS) [3].
- Flank Pain: Patients may report unilateral or bilateral flank pain, which can be acute or chronic depending on the onset of the compressive process.
- Palpable Mass: In cases of significant hematoma or tumor, a palpable mass may be detected on physical examination.

Symptoms

The symptoms associated with Page kidney can include:
- Hematuria: Blood in the urine may occur due to renal injury or irritation.
- Dysuria: Patients may experience pain or difficulty during urination.
- Nausea and Vomiting: These symptoms can arise from pain or renal dysfunction.
- Fatigue: Generalized fatigue may be present due to anemia or renal insufficiency.

Patient Characteristics

Demographics

• Age: Page kidney can occur in individuals of any age, but it is more commonly seen in adults, particularly those who may be involved in activities with a higher risk of trauma.
• Gender: There is no significant gender predisposition, although some studies suggest a higher incidence in males due to higher rates of trauma exposure[4].

Risk Factors

• History of Trauma: Patients with a history of abdominal trauma are at increased risk.
• Surgical History: Those who have undergone abdominal or renal surgeries may be more susceptible to developing hematomas.
• Underlying Renal Disease: Pre-existing renal conditions may exacerbate the effects of Page kidney.

Comorbidities

Patients may present with comorbid conditions that can complicate the clinical picture, such as:
- Hypertension: Often a significant comorbidity due to renal ischemia.
- Diabetes Mellitus: Can contribute to renal dysfunction and complicate management.
- Obesity: May increase the risk of trauma and complicate surgical interventions.

Conclusion

Page kidney (ICD-10 code N26.2) is a significant clinical condition that arises from external compression of the kidney, often due to hematomas or masses. The clinical presentation can vary widely, with hypertension, flank pain, and hematuria being common symptoms. Understanding the signs, symptoms, and patient characteristics associated with this condition is crucial for timely diagnosis and management. Early intervention can prevent further renal damage and improve patient outcomes. If you suspect Page kidney in a patient, a thorough evaluation including imaging studies and laboratory tests is essential to confirm the diagnosis and guide treatment.

The ICD-10-CM code N26.2 specifically refers to "Page kidney," a condition characterized by the development of a renal mass due to the presence of a hematoma or fluid collection around the kidney, often resulting from trauma. Understanding alternative names and related terms for this condition can enhance clarity in medical documentation and communication.

Alternative Names for Page Kidney

1. Page's Kidney: This is a direct variation of the term, often used interchangeably.
2. Renal Hematoma: While not synonymous, this term describes the underlying condition that can lead to Page kidney, where blood accumulates around the kidney.
3. Subcapsular Hematoma: This term refers to a hematoma located beneath the kidney's capsule, which can be a contributing factor to Page kidney.
4. Perirenal Hematoma: Similar to renal hematoma, this term emphasizes the location of the hematoma surrounding the kidney.

Related Terms

1. Renal Trauma: This term encompasses any injury to the kidney, which can lead to conditions like Page kidney.
2. Kidney Injury: A broader term that includes various types of damage to the kidney, including those that may result in Page kidney.
3. Fluid Collection: This term can refer to any accumulation of fluid around the kidney, which may be associated with Page kidney.
4. Chronic Kidney Disease (CKD): While not directly related, chronic conditions can complicate or be exacerbated by acute events like Page kidney.

Clinical Context

Understanding these alternative names and related terms is crucial for healthcare professionals when diagnosing and coding conditions accurately. The use of precise terminology ensures effective communication among medical staff and aids in the proper documentation of patient records, which is essential for treatment planning and insurance purposes.

In summary, while the primary ICD-10 code N26.2 refers specifically to Page kidney, various alternative names and related terms exist that can provide additional context and clarity in clinical discussions.

The ICD-10 code N26.2 refers to "Page kidney," a condition characterized by renal impairment due to the compression of the kidney, typically caused by a hematoma or fluid collection that develops around the kidney. This condition can lead to hypertension and renal dysfunction if not addressed promptly.

Diagnostic Criteria for Page Kidney (ICD-10 Code N26.2)

1. Clinical Presentation:
   - Symptoms: Patients may present with symptoms such as flank pain, hematuria (blood in urine), hypertension, and signs of renal impairment. The presence of these symptoms can prompt further investigation.
   - Physical Examination: A physical examination may reveal tenderness in the flank area or abdominal distension, which can indicate the presence of a mass or fluid collection.

2. Imaging Studies:
   - Ultrasound: An abdominal ultrasound is often the first imaging modality used. It can help identify the presence of a hematoma or fluid collection surrounding the kidney.
   - CT Scan: A computed tomography (CT) scan of the abdomen is more definitive and can provide detailed information about the size and extent of the hematoma, as well as any associated renal damage. It can also help rule out other causes of renal impairment.

3. Laboratory Tests:
   - Blood Tests: Laboratory tests may include a complete blood count (CBC) to check for anemia or signs of infection, and renal function tests (serum creatinine and blood urea nitrogen) to assess the degree of renal impairment.
   - Urinalysis: A urinalysis can help identify hematuria or other abnormalities that may suggest renal pathology.

4. Differential Diagnosis:
   - It is essential to differentiate Page kidney from other conditions that can cause similar symptoms, such as renal tumors, pyelonephritis, or other forms of renal obstruction. This may involve additional imaging or diagnostic procedures.

5. History of Trauma or Surgery:
   - A history of recent trauma, surgery, or procedures involving the kidney or surrounding structures can be a significant factor in diagnosing Page kidney, as these events can lead to hematoma formation.

Conclusion

The diagnosis of Page kidney (ICD-10 code N26.2) relies on a combination of clinical evaluation, imaging studies, and laboratory tests. Early recognition and treatment are crucial to prevent long-term complications such as chronic kidney disease or persistent hypertension. If you suspect Page kidney, it is advisable to consult a healthcare professional for a thorough assessment and appropriate management.

Clinical Description of ICD-10 Code N26.2: Page Kidney

Overview of Page Kidney

Page kidney, classified under ICD-10 code N26.2, refers to a condition characterized by the development of a contracted kidney due to external compression, typically from a hematoma or a mass. This condition is named after Dr. Page, who first described it in the context of renal trauma. The compression leads to ischemia and subsequent atrophy of the renal parenchyma, resulting in a reduction in kidney size and function.

Etiology and Pathophysiology

The primary cause of Page kidney is often related to trauma, which can lead to the accumulation of blood (hematoma) around the kidney. This hematoma exerts pressure on the renal tissue, causing it to become ischemic. Other potential causes include:

• Tumors: Neoplastic growths can also compress the kidney.
• Cysts: Large renal cysts may exert pressure on the kidney.
• Vascular issues: Conditions that affect blood flow to the kidney can contribute to its contraction.

The pathophysiological process involves the loss of renal parenchyma due to prolonged ischemia, leading to a decrease in kidney size and function, which can ultimately result in renal insufficiency if not addressed promptly[1][2].

Clinical Presentation

Patients with Page kidney may present with a variety of symptoms, including:

• Flank pain: Often due to the underlying hematoma or mass.
• Hematuria: Blood in the urine may occur, particularly if there is associated trauma.
• Hypertension: Secondary hypertension can develop due to renal ischemia and activation of the renin-angiotensin-aldosterone system (RAAS).
• Renal insufficiency: In severe cases, patients may exhibit signs of decreased kidney function.

Diagnosis

Diagnosis of Page kidney typically involves a combination of clinical evaluation and imaging studies. Key diagnostic steps include:

• Ultrasound: This imaging modality can help identify the presence of a hematoma or mass around the kidney.
• CT scan: A computed tomography scan provides a more detailed view of the kidney and surrounding structures, confirming the diagnosis and assessing the extent of the condition.
• Laboratory tests: Blood tests may reveal signs of renal impairment, such as elevated creatinine levels.

Treatment

Management of Page kidney focuses on addressing the underlying cause of the compression. Treatment options may include:

• Observation: In cases where the hematoma is small and asymptomatic, careful monitoring may be sufficient.
• Surgical intervention: If the hematoma is large or causing significant symptoms, surgical drainage or removal may be necessary.
• Management of hypertension: Antihypertensive medications may be required to control blood pressure if secondary hypertension is present.

Conclusion

ICD-10 code N26.2 for Page kidney encapsulates a significant clinical condition resulting from external compression of the kidney, primarily due to hematomas or masses. Early diagnosis and appropriate management are crucial to prevent long-term renal damage and associated complications. Understanding the clinical presentation, diagnostic methods, and treatment options is essential for healthcare providers dealing with this condition[3][4].

For further information or specific case studies, consulting nephrology literature or clinical guidelines may provide additional insights into the management of Page kidney.

Page kidney, classified under ICD-10 code N26.2, refers to a condition where a kidney is compressed by a hematoma or fluid collection, often resulting from trauma or surgical procedures. This condition can lead to renal dysfunction due to the impaired blood flow and pressure on the kidney. Understanding the standard treatment approaches for Page kidney is crucial for effective management and recovery.

Diagnosis and Initial Assessment

Before treatment can begin, a thorough diagnosis is essential. This typically involves:

• Clinical Evaluation: Assessing symptoms such as flank pain, hematuria (blood in urine), and hypertension.
• Imaging Studies: Ultrasound or CT scans are commonly used to visualize the kidney and identify the presence of a hematoma or fluid collection.

Treatment Approaches

1. Observation and Monitoring

In cases where the hematoma is small and the patient is stable, a conservative approach may be adopted. This includes:

• Regular Monitoring: Follow-up imaging and clinical assessments to ensure that the hematoma is not enlarging and that kidney function remains stable.
• Symptomatic Management: Pain management and monitoring for any signs of complications.

2. Interventional Procedures

If the hematoma is large or causing significant symptoms, more invasive treatments may be necessary:

• Drainage: Percutaneous drainage of the hematoma can relieve pressure on the kidney. This is often guided by imaging techniques to ensure accurate placement of the drainage catheter.
• Surgical Intervention: In cases where drainage is not effective or if there are complications (such as infection or persistent bleeding), surgical exploration may be required to remove the hematoma or repair any underlying issues.

3. Management of Complications

Patients with Page kidney may develop complications that require additional management:

• Hypertension: Due to renal ischemia, patients may experience elevated blood pressure. Antihypertensive medications may be prescribed to manage this condition.
• Renal Function Monitoring: Regular assessment of renal function through blood tests (e.g., serum creatinine) is crucial to detect any deterioration early.

4. Long-term Follow-up

Post-treatment, patients should be monitored for:

• Renal Recovery: Assessing kidney function over time to ensure recovery.
• Recurrence: Monitoring for any signs of recurrent hematoma or other complications.

Conclusion

The management of Page kidney (ICD-10 code N26.2) involves a combination of observation, interventional procedures, and long-term follow-up to ensure optimal outcomes. Early diagnosis and appropriate treatment are key to preventing complications and preserving kidney function. As with any medical condition, individualized treatment plans should be developed based on the patient's specific circumstances and overall health status. Regular follow-up with healthcare providers is essential to monitor recovery and manage any potential complications effectively.