Objective• To detail the 9-year experience of renal trauma at a modern Level 1 trauma centre and report on patterns of injury, management and complications. Patients and methods• We analysed 338 patients with renal injuries who presented to our institution over a 9-year period.• Data on demographics, clinical presentation, management and complications were recorded. Results• Males comprised 74.9% of patients with renal injuries and the highest incidence was amongst those aged 20-24 years.• Blunt injuries comprised 96.2% (n = 325) of all the renal injuries, with road trauma being the predominant mechanism accounting for 72.5% of injuries.• The distribution of injury grade was; 21.6% grade 1 (n = 73), 24.3% grade 2 (n = 82), 24.9% grade 3 (n = 84), 16.6% grade 4 (n = 56), and 12.7% grade 5 (n = 43).• Conservative management was successful in all grade 1 and 2 renal injuries, and 94.9%, 90.7% and 35.1% of grade 3, 4 and 5 injuries respectively. • All but one of the 13 patients with penetrating injuries were successfully managed conservatively. Conclusions• Road trauma is the greatest cause of renal injury.• Most haemodynamically stable patients are successfully managed conservatively.

Therapeutic study, level IV; prognostic study, level III.