Treatment of Renal Injury: Practical Approach

Abstract

Jong Bouk Lee From the Department of Urology, National Medical Center, Seoul, Korea Traumatic injuries are the leading cause of death in young people, and the renal injury is one of the major abdominal trauma. Hematuria is the most common sign of renal trauma, however the degree of hematuria and the severity of renal injury do not correlate consistently. Criteria for radiographic investigation is somewhat different according to the injury mechanism and an age. Excellent imaging modality such as computerized tomograph has made it possible to delineate not only detailed anatomic configuration for renal laceration itself but the presence of associated intraabdominal organ injury. Renal injury may be presented as one of the multiple trauma, thus full evaluation for the overall injury severity of the patient is mandatory. Advanced supportive care techniques and awareness of the kidney's capacity for healing have facilitated non-operative management. Nowadays, operative exploration is indicated only in selected patients with major renal injury even in the patients with penetrating trauma, and high rates of renal reconstruction is possible through early vascular control. Urologic surgeon, as a major member of the trauma team, should be expertized in the surgical skills for reconstruction as well as acquiring up-to-date knowledge on diagnosis and management of renal trauma. (Korean J Urol 2007;48:885-896)