This case involves a male patient in Massachusetts who suffered injuries following a motor vehicle accident. He was subsequently treated for injuries to his cervical discs, as well as lower back pain. Since the accident, he gradually developed sweating, heart palpitations, and trouble walking. He initially saw a cardiologist, who discovered no cardiac abnormalities. He was then referred to a nephrologist and underwent an ultrasound, where it was discovered that one of his kidneys was significantly smaller than the other. It was alleged that the injuries to his kidney were caused by his involvement in the motor vehicle accident.
Question(s) For Expert Witness
- 1. Do you routinely treat patients similar to the one described in the case?
- 2. What could be some of the potential causes of a shrinking kidney?
- 3. Could it be a result of trauma from a motor vehicle accident?
Expert Witness Response E-015424
Did he have any imagining studies prior to his accident? He could have had a smaller kidney even prior to the accident. I will also need to know what kind of workup was done to rule out hyperaldosteronism / pheochromocytoma. Were other secondary causes for hypertension worked up in this patient? Again, it’s important to review all his tests prior, during, and after the accident. I have had two similar patients who developed hypertension following a car accident but they were both treated surgically with revascularization and were cured. As I stated, this a rare condition but can occur. I am a hypertension specialist and director of our hypertension center and although a nephrologist, my outpatient clinics are dedicated only to the workup and management of patients with hypertension.