[Clinical studies of renal trauma].
A total of 70 patients with renal trauma were treated at the Department of Urology, Nara Medical University and Nara Prefectural Hospital, including Life-Saving Emergency center, from January 1982 to June 1993. They were between 3 and 79 years old (mean 30.0) and preponded to the younger generation. The main cause of injury was traffic accident in 46 cases (65.7%). According to the Classification of Renal Injury by the Japanese Association for the Surgery of Trauma in Japan, there were 31 cases (44.3%) of type I (subcapsular injury), 18 cases (25.7%) of type II (superficial injury), 15 cases (21.4%) of type III (deep injury), and 6 cases (8.6%) of type IV (pedicle injury). Surgical treatment was performed in 17 cases (24.2%). The major associated injuries were bone fracture in 32 cases (45.7%), lung injury in 17 cases (24.2%), and liver injury in 15 cases (21.4%). Furthermore, hydronephrosis and ureteral tumors were incidentally found in 4 and 1 patient during the course of treatment for renal trauma. Post-traumatic plasma renin activities (PRA) in types III and IV were significantly higher than those in types I and II. Hypertension developed in 1 case of types I and II and 4 cases of types III and IV. The mean level of PRA was significantly decreased 2 years after renal injury in both groups. We should bear in mind that renal trauma may be associated with other urological diseases such as hydronephrosis and urological malignancies, and post-traumatic PRA should be followed carefully.
Department of Urology, Nara Medical University.
M
M
Tanaka
S
S
Ozono
S
S
Kimura
Y
Y
Tanaka
K
K
Yoshida
Y
Y
Hirao
E
E
Okajima
Y
Y
Kaneko
Y
Y
Ueda
K
K
Kamada
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000150:complications; D006978:Hypertension, Renovascular / Q000209:etiology; D007668:Kidney / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012083:Renin / Q000097:blood; D014516:Ureteral Neoplasms / Q000150:complications
D012083:Renin