Renal Trauma Management in 8 Cities of Iran

This prospective study, conducted in 8 cities of Iran from 1999 to 2000. Out of total 16,573 trauma patients, 106 (0.63%) included in this study had renal injury. This study aimed at investigation of incidence, etiology and management of renal trauma patients in Iran. They were 87 (82.1%) male and 19 (17.9%) female. Renal trauma mechanism was mainly blunt injury (93.4%). Road traffic crashes (61.3%) and falls (22.7%) were the most leading causes of trauma. Patients had different grades of renal trauma as follow: Sixty- six (62.3%) grade I, 14 (13.2%) grade II, 10 (9.4%) grade III, 8 (7.5%) grade IV and 8 (7.5%) grade V. Out of 106 patients, eighty-three (78.3%) patients managed conservatively, most had grade I injury (P<0.0001). Twenty-three (21.7%) patients underwent an operation including: 5 (4.7%) nephrorrhaphy; 6 (5.7%) partial nephrectomy, and 12 (11.8%) total nephrectomy. The higher the grade of renal trauma, the more invasive intervention was needed, as all patients with grade V underwent total nephrectomy (P<0.0001). Six patients (5.66%) passed away, three due to severe renal injury and hemorrhage, and three because of reasons unrelated to renal trauma. We concluded that most renal traumas are blunt type and low grade injury which can be managed successfully non-operatively. Conservative management is the treatment of choice for those with stable hemodynamic state.