High-Grade Renal Trauma Due to Blunt Injury: Do All Require Surgical Intervention?

Background

Renal trauma management has increasingly shifted toward non-operative treatment, particularly in hemodynamically stable patients. Advances in imaging, resuscitation, and monitoring have improved the outcomes of conservative management, even in high-grade injuries. Blunt trauma, most commonly from falls, is the leading cause, and renal injuries often occur within the context of polytrauma involving multiple organ systems. Management is primarily guided by hemodynamic stability, overall clinical condition, existing comorbidities, and the severity of injury as determined by the American Association for the Surgery of Trauma (AAST) grading system. This study aimed to describe the management strategies and clinical outcomes of patients with high-grade blunt renal trauma (AAST grades III–V), with particular emphasis on the use of conservative management in selected patients.