AB16. Renal trauma: epidemiology, management and the AUA guidelines

The kidney is the most common genitourinary organ injured from external trauma, occurring in 1-5% of all injuries. The vast majority of kidney injuries can be successfully managed nonoperatively. Blunt traumas are more frequent than penetrating. Penetrating trauma is more common in urban areas, is commonly caused by gunshot or stab wounds, and more commonly requires exploration. Blunt trauma results from falls from heights, motor vehicle and motorcycle crashes or blunt assaults. An estimated 2% of blunt injuries require exploration while over 50% of penetrating do. Similar to other solid organ injuries such as spleen and liver, advances in staging techniques (computed tomography) have helped promote non-operative management of renal injuries. Nevertheless, certain severely injured kidneys require exploration and reconstruction, or rarely, removal. Advances in embolization techniques have produced a useful adjunct treatment modality for renal trauma. Ultimately, the objective of managing these patients is to stem life-threatening bleeding while retaining enough nephron mass to avoid end-stage renal disease.