Severity of Renal Injuries in Correlation with Mechanism of Trauma and Its Management: A Retrospective Cross Sectional Study

Background: Renal trauma is the most common injury of the genitourinary tract and accounts for a significant proportion of abdominal solid organ injuries. Recent advances in imaging and critical care have resulted in a paradigm shift toward non-operative management (NOM) in hemodynamically stable patients. The objective is to evaluate the severity of renal injuries according to the mechanism of trauma, assess the role of diagnostic modalities in grading renal trauma, and analyze management strategies and clinical outcomes. Material and Methods: A retrospective cross-sectional study was conducted in the Department of Urology, Government General Hospital, Kurnool, from January 2022 to December 2025. 40 patients with documented renal trauma were included. Data regarding demographics, mechanism of injury, AAST renal injury grade, associated injuries, management modality and outcomes were collected from hospital records. All patients underwent contrast-enhanced computed tomography (CECT) of the abdomen and pelvis for grading of renal injuries. Results: The mean age was 30 years. There were 36 males (90%) and 4 females (10%). Blunt trauma accounted for 36 cases (90%) and penetrating trauma for 4 cases (10%). Hematuria was the most common presenting symptom and was observed in 36 (90%) patients. Associated injuries were present in 12 (30%) patients, while 28 (70%) had isolated renal trauma. Grade III renal injury was the most common injury pattern in 20(50%) patients. Conservative management was successful in 34 (85%) of patients, while nephrectomy was required in 4 (10%) patients. Mortality was observed in 1 patient (2.5%) due to associated injuries. Conclusion: Most renal trauma patients can be managed successfully with non-operative management. Accurate grading using CECT and careful hemodynamic assessment are essential for optimal treatment planning and renal preservation.

Keywords: Renal trauma; AAST grading; Blunt trauma; Non-operative management; Nephrectomy; Urological trauma.