Abstract: PD63-03
Sources of Funding: none

Introduction

The majority of patients with renal trauma are managed conservatively regardless of grade of injury once they are stable with resuscitation. However, it is not known what happens to the function of the affected kidney following initial loss due to trauma._x000D_ _x000D_

Methods

In this prospective study conducted from July 2014 to December 2015 patients with unilateral renal injury and contra-lateral normal kidney were included. Their renal injury was graded according to American Association for the Surgery of Trauma. They underwent first DMSA renal scan within 7 days and second DMSA scan 3 months after trauma for assessment of early and delayed relative function of injured kidney respectively. Patients requiring any surgical and radiological intervention were excluded from the study

Results

Total 32 patients fulfilled the inclusion and exclusion criteria and completed the study. The mean early relative function of the injured kidney (35.7 ± 15.8 %) improved significantly at 3 months (39.6 ± 17.7%, p < 0.001). When we considered grade I to grade III as low grade we observed that the improvement was significant in kidneys with low grade injury (from 46.1 ± 3.2% to 50.4 ± 2.7%, p < 0.01) and grade IV injury. There was no improvement of function of kidney with grade V injury (Table I). The preserved function and improvement of function was associated with low grade injury, low degree of parenchymal loss and no vascular injury (p<0.01, Table 2). On multivariate analysis only vascular injury was associated with no significant improvement in function. The relative renal function improved in 25 patient remained almost the same in 3 patients and decreased in 4 patients. Significantly a high proportion of kidney with high grade injury, more than 50% of parenchyma loss and vascular injury had loss of relative function more than 5 %.

Conclusions

Retained renal function following conservative management depends on grade of renal injury, degree of parenchymal loss and vascular injury. The improvement of function of injured kidney occurs with passage of time in the majority except those with vascular injury.

Funding

none