TY - JOUR
T1 - Renovascular injury
T2 - An argument for renal preservation
AU - Barsness, Katherine A.
AU - Bensard, Denis D.
AU - Partrick, David
AU - Hendrickson, Richard
AU - Koyle, Martin
AU - Calkins, Casey M.
AU - Karrer, Frederick
PY - 2004/8
Y1 - 2004/8
N2 - Background: Renovascular injury is uncommon among children. This study hypothesized that preservation of the severely injured kidney can be achieved safely without renal insufficiency, postinjury hypertension, or the need for hemodialysis. Methods: Retrospective chart review of renal injuries seen between 1997 and 2091 at a level 1 pediatric trauma center was conducted. Severity of injury was graded by the American Association for the Surgery of Trauma Organ Injury Severity Scale. The outcome variables included the need for hemodialysis, impaired renal function (creatinine), and postinjury hypertension. Results: In this study, 34 children presented with grade 1, 2, or 3 injury (74%), whereas 13 children presented with grade 4 or 5 renovascular injury (28%). The children with unilateral renovascular injury who underwent either nephrectomy or renal preservation had comparable outcomes with no hypertension, hemedialysis, or renal insufficiency in either group. Conclusions: The treatment outcomes were not different between the patients who underwent renal preservation and those who had immediate nephrectomy. The authors conclude that renal preservation should be attempted for all children with grade 4 or 5 renovascular injury.
AB - Background: Renovascular injury is uncommon among children. This study hypothesized that preservation of the severely injured kidney can be achieved safely without renal insufficiency, postinjury hypertension, or the need for hemodialysis. Methods: Retrospective chart review of renal injuries seen between 1997 and 2091 at a level 1 pediatric trauma center was conducted. Severity of injury was graded by the American Association for the Surgery of Trauma Organ Injury Severity Scale. The outcome variables included the need for hemodialysis, impaired renal function (creatinine), and postinjury hypertension. Results: In this study, 34 children presented with grade 1, 2, or 3 injury (74%), whereas 13 children presented with grade 4 or 5 renovascular injury (28%). The children with unilateral renovascular injury who underwent either nephrectomy or renal preservation had comparable outcomes with no hypertension, hemedialysis, or renal insufficiency in either group. Conclusions: The treatment outcomes were not different between the patients who underwent renal preservation and those who had immediate nephrectomy. The authors conclude that renal preservation should be attempted for all children with grade 4 or 5 renovascular injury.
KW - Children
KW - Hypertension
KW - Renal
KW - Trauma
KW - Vascular
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U2 - 10.1097/01.TA.0000141329.74804.E2
DO - 10.1097/01.TA.0000141329.74804.E2
M3 - Review article
C2 - 15345978
AN - SCOPUS:4444237084
SN - 0022-5282
VL - 57
SP - 310
EP - 315
JO - Journal of Trauma - Injury, Infection and Critical Care
JF - Journal of Trauma - Injury, Infection and Critical Care
IS - 2
ER -