Renal injury grading

Abdomen

Renal Injury Grading

Grade I

Hematuria with normal kidney, renal contusion, or nonexpanding subcapsular hematoma.

Grade II

Nonexpanding perirenal hematoma, confined to the retroperitoneum. Laceration < 1 cm in depth without urinary extravasation.

Grade III

Laceration > 1 cm parenchymal depth, without collecting system rupture or urinary extravasation. Vascular injury confined within the perirenal fascia.

Grade IV

Laceration through renal cortex, medulla, and collecting system; renal artery or vein injury with contained hemorrhage.

Grade V

Shattered kidney; renal hilum avulsion with devascularized kidney

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All grade I and II injuries and 90% of grade III and IV injuries are managed con- servatively. Grade V injuries usually require nephrectomy.