Trauma remains to be one of the highest causes of death in patients under the age of 40. In abdominal trauma, the third most commonly injured organ is the kidney. With the advancements in imaging and technology, there has been an increasing shift towards conservative or non-operative management. Renal trauma remains to be complex and challenging clinical entity. Incorporating the available current guidelines into clinical practice ensures a structured and evidence-based approach to renal trauma management. However, each case necessitates careful consideration of patient factors, injury severity, and associated injuries for an individualised treatment plan. There is a current paucity in the literature in regards to Australia trauma data, and no published literature from NSW.

A retrospective data collection was performed for trauma patients managed by Royal North Shore Hospital over a 5-year period (2019-2023, inclusive) with a renal injury. Patients were identified using specific diagnosis related group codes. Data included demographics, mechanism, American Association for the Surgery and Trauma (AAST) grade, associated symptoms and injuries, management and complications.

83 patients were identified, 78.3% male, with an average age of 44years. Low-grade AAST Grade I–III injuries comprised of 71% of injuries, AAST Grade IV accounted for 22.9% and 6% were grade V. The most common mechanism of injury was road accidents accounting for 41%, followed by fall-related injuries (35%). Penetrative trauma accounted for 4.8% of presentations. Intervention was required in all grade V patients - either radiological intervention or a nephrectomy, due to haemodynamic instability.

The majority of renal trauma encountered occurred in men which follows trends of other studies published. Road trauma is the leading cause of renal injury followed by fall related injuries. Haemodynamically stable patients were all managed conservatively, and all grade V injuries needed intervention.