Prospective observational study with an abbreviated protocol in the management of blunt renal injury in children

J Pediatr Surg. 2014 Jan;49(1):198-200; discussion 200-1. doi: 10.1016/j.jpedsurg.2013.09.053. Epub 2013 Oct 5.


Background: There are no published management schemes for blunt renal injuries. We are conducting a 2-center prospective observational study with a fixed management scheme.

Methods: Children with CT proven renal injuries were enrolled with permission. Ambulation is allowed when able regardless of grade. Discharge occurs when tolerating a diet and pain is controlled regardless of hematuria. Urinalysis occurs at follow up in 2-4weeks and repeated as indicated.

Results: Between 9/2008 and 9/2012, 70 patients were enrolled. Mean age was 11.8years (3-17), and 70% were male. The mean grade of injury was 2.8±1.1 [1-5]. One nephrectomy (1.4%) was performed for a grade 5 injury. Other renal interventions included an embolization for the hilar bleed and one cystotomy for a clot. Mean LOS was 2.9days±2.4days. In patients without other major injury, LOS was 1.9±1.7days (0.4-8days). There were 5 (7%) readmissions: 3 for pain, 1 for hematuria, and 1 for a bladder clot. 58 patients (83%) gave urinalysis samples at initial follow up (med 18days), where 31 (53%) were positive for blood.

Conclusions: Children with blunt renal injury may benefit from management without strict bedrest guidelines. Hematuria appears to have little influence on recovery.

Keywords: Children; Management; Renal trauma.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Bed Rest
  • Child
  • Child, Preschool
  • Clinical Protocols*
  • Diet
  • Disease Management
  • Embolization, Therapeutic / statistics & numerical data
  • Female
  • Hematuria / etiology
  • Humans
  • Infant
  • Kidney / diagnostic imaging
  • Kidney / injuries*
  • Kidney / surgery
  • Male
  • Multiple Trauma / epidemiology
  • Nephrectomy / statistics & numerical data
  • Pain Management
  • Practice Guidelines as Topic
  • Prospective Studies
  • Tomography, X-Ray Computed
  • Trauma Severity Indices
  • Urinalysis / statistics & numerical data
  • Walking
  • Wounds, Nonpenetrating / complications
  • Wounds, Nonpenetrating / diagnostic imaging
  • Wounds, Nonpenetrating / epidemiology
  • Wounds, Nonpenetrating / therapy*