Overview
Renal trauma, including laceration of the left kidney, can lead to significant morbidity. Management strategies aim to prevent complications such as acute kidney injury and the need for dialysis.Diagnosis
Grading of renal injuries is typically performed using the American Association for the Surgery of Trauma (AAST) organ injury scale.Management
Aggressive intravenous fluid resuscitation (IVFR) is recommended to decrease the incidence of acute renal failure (ARF) and the need for dialysis in patients with rhabdomyolysis 1.
Urine alkalization with bicarbonate and the use of mannitol are not shown to improve the incidence of ARF and need for dialysis in patients with rhabdomyolysis 1.
Compartment syndrome associated with rhabdomyolysis requires identification and release 1.Key Recommendations
Aggressively administer intravenous fluids to improve outcomes of acute renal failure in patients with rhabdomyolysis 1. (Evidence: Weak)
Do not administer bicarbonate to improve outcomes of acute renal failure in patients with rhabdomyolysis 1. (Evidence: Weak)
Do not administer mannitol to improve outcomes of acute renal failure in patients with rhabdomyolysis 1. (Evidence: Weak)References
1 Sawhney JS, Kasotakis G, Goldenberg A, Abramson S, Dodgion C, Patel N et al.. Management of rhabdomyolysis: A practice management guideline from the Eastern Association for the Surgery of Trauma. American journal of surgery 2022. link