Comparison of Blunt Renal Injury between Children and Adults: Effect of the Causes on Severity of Renal Injury

Lee, Jae Hyun; Yoon, Sang Jin; Lee, Jong Bouk

Abstract

PURPOSE: This study was performed to determine whether pediatric patients are more susceptible for major renal injury than adults, and the reasons evaluated.
MATERIALS AND METHODS
The medical records of 209 consecutive patients (47 children and 162 adults) with a blunt renal injury were retrospectively reviewed. The renal injuries were graded on a five point scale based on the results of computerized tomography. The causes of the blunt renal injury were classified into three groups; traffic accidents, falls and other blunt trauma. The degree of renal injury was compared according to the cause, and whether there were differences in the causes of renal injury and the number of patients with major renal injury between children and adults determined.
RESULTS
The main cause of the renal injuries was traffic accidents in adult, but falls in pediatric patients. Overall 21 of the 47 children (44.7%) and 45 of the 162 adults (27.8%) had major renal injuries (p<0.05). 38 (52.8%) of the 72 patients were injured by falls, as opposed to traffic accidents, so there were significantly more fall induced major renal injuries (p<0.05).
CONCLUSIONS
Children are more likely to sustain major renal injury from a blunt abdominal trauma, and the patients injured by falls have more severe renal injuries than those of other causes. Also, the main cause of a renal injury was traffic accidents in adult, but falls in pediatric patients. From the different origins of the causes of injury, as well as the unique pediatric anatomic structures, pediatric patients are more susceptible to major renal injury than adults.