SRS24 - Management of adult and paediatric renal trauma in a uk major trauma centre

Introduction The kidney is the most frequently injured organ in the urinary system. Management of renal trauma has evolved over the years, with guidelines advocating non-operative management approaches, judicious use of imaging and structured follow-up. Whilst outcomes in the adult population are well-described, paediatric cohorts are less frequently audited. We aimed to evaluate the management and follow-up across both groups against international standards. Methods A retrospective review was performed of all renal trauma cases (February 2020–February 2025) admitted to a single UK Major Trauma Centre. Cases were identified via prospectively maintained trauma registries and stratified into adults (>16 years) and paediatrics (≤16 years). Exclusion criteria included non-traumatic renal pathology and incomplete records. Demographics, injury grade, imaging, interventions and outcomes data were evaluated. Compliance with EAU/AUA guideline criteria was analysed for each cohort. Results 92 patients were identified: 79 adults and 13 paediatric, with a male predominance across both groups (77 and 69% respectively). The majority of stable patients were managed non-operatively, achieving an overall renal salvage rate of 96%. Delayed-phase imaging at initial CT was underutilised (<50%), despite most patients being stable. Blood pressure monitoring advice at discharge was infrequently documented in both cohorts. Mortality was 0% in paediatrics and low overall. Conclusions Management largely aligned with guidelines, with excellent renal salvage and low mortality rates. Priorities are standardising delayed-phase imaging on initial CT where feasible and embedding blood-pressure monitoring advice in discharge documentation. Our findings are informing new local renal trauma protocols; re-audit is planned.