Davis et al identified risk factors associated with the need for nephrectomy following renal trauma. The authors are from Loyola University Medical Center in Maywood, Illinois.


Major predictors for the need of nephrectomy:

(1) Grade 4 or 5 renal trauma (50% and 88 % respectively)

(2) gunshot wound or other penetrating injury


Additional predictors for the need of nephrectomy:

(3) hemodynamic instability

(4) overall injury severity (ISS >= 16)

(5) ongoing transfusion requirement

(6) Glasgow coma scale <= 10



• The odds ratios for the grade of renal trauma and penetrating injury from multivariate analysis are reported (both in the order of 20).

• The odds ratios for the other factors are not given although reported as being significant. The cutoffs for the additional predictors are not stated; the values are taken from Table 2, page 166.


Findings usually not associated with a need for nephrectomy:

(1) Grade 1 to 3 renal trauma


If the patient is hemodynamically stable, then a helical CT scan is the preferred imaging study to evaluate a patient with hematuria.


To read more or access our algorithms and calculators, please log in or register.