Management of Kidney Injuries

The purpose of this paper is to present a plan of management of kidney injuries that has been evolved from our experiences in civilian urologic practice. From an analysis of 66 cases and a review of articles in the recent literature, certain observations seem warranted. When confronted with a patient who may have sustained trauma to the kidney, the initial problem is to determine whether the kidney actually has been injured. Significant pain or tenderness in the renal area, gross hematuria, and/or a mass in the flank constitute presumptive evidence of kidney involvement, and if present it then becomes the duty of the physician to determine the extent of the injury. Once this has been ascertained, logical treatment may be started. Of paramount importance is knowledge of the status of the other kidney. It should be remembered that concomitant damage to other viscera, such as the liver, bowel, or spleen,