Sir, Page kidney is the external compression of a kidney. The condition is usually caused by a subcapsular haematoma, associated with high blood pressure and occasional renal failure, as described by Irwin Page in an animal model with cellophane papers wrapped round the kidney in 1939 and, subsequently, clinically in 1955 [1,2]. The present case illustrates, in a patient with a single functioning kidney, the successful management of a spontaneous subcapsular haematoma that was causing both acute renal failure and hypertension. A 36-year-old female presented with a left-sided loin pain. At the age of 2 years she had undergone right nephrectomy for a Wilm’s tumour and left-sided lower lobectomy for pulmonary metastatic disease, followed by chemotherapy and radiotherapy. Six months before presentation, following her first pregnancy, she was diagnosed with dilated cardiomyopathy, for which she was given candesartan, carvedilol and warfarin. She was in pain, with tenderness over the left costovertebral angle. Her blood pressure was 94/57 mmHg. Investigation showed INR 2.7, C-reactive protein 20 mg/l and serum creatinine 136mmol/l. An ultrasound scan revealed a mixed reflective collection, adjacent to the postero-lateral aspect of her left kidney. Spectral Doppler analysis of the segmental arteries within the kidney showed a high-resistance pattern with complete loss of normal diastolic flow; but the renal vein was patent. A non-contrast computed tomography (CT) scan confirmed the finding of a subcapsular haematoma (Figure 1). In the following 48 h she became hypertensive, oliguric and her serum creatinine rose to 508mmol/l. Drainage was arranged. After reversal of anticoagulation, an 8F pigtail catheter was inserted percutaneously into the haematoma under ultrasound guidance and 100 ml sero-sanguineous fluid was drained. Ultrasound after 24 h showed a reduction in size