The incidence of long-term hypertension in children after high-grade renal trauma

Fuchs, Molly; Anderson, Ross; Myers, Jeremy B.; Wallis, M. Chad

doi:10.1016/j.jpedsurg.2015.05.014

Cited by 16 publications

(6 citation statements)

References 12 publications

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“…Low-grade kidney injuries have a very low rate of late complication in pediatric patients; therefore, scheduled imaging follow-up in the potential complications is not indicated [247, 250]. The reported incidence of renal trauma-induced hypertension is 0–6.6% [244, 251–254], but in general, all those who are normotensive in the immediate post-trauma period usually do not develop signs of hypertension during follow-up [251].…”

Section: Methodsmentioning

confidence: 99%

Kidney and uro-trauma: WSES-AAST guidelines

et al. 2019

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Renal and urogenital injuries occur in approximately 10-20% of abdominal trauma in adults and children. Optimal management should take into consideration the anatomic injury, the hemodynamic status, and the associated injuries. The management of urogenital trauma aims to restore homeostasis and normal physiology especially in pediatric patients where non-operative management is considered the gold standard. As with all traumatic conditions, the management of urogenital trauma should be multidisciplinary including urologists, interventional radiologists, and trauma surgeons, as well as emergency and ICU physicians.

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Section: Methodsmentioning

confidence: 99%

Kidney and uro-trauma: WSES-AAST guidelines

et al. 2019

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“…LeeVan et al , in their recent systematic review, found 10 studies that reported no cases developing hypertension and nine studies that recorded transient or long‐term hypertension in 5–15% of patients on follow‐up. In a further study with a large series of 62 children (AAST grade III–V injury), 6.5% of children developed hypertension with half of them being transient only . Although the risk of hypertension developing after renal trauma is perceived to be low, some studies have reported the development of renal scarring in children, especially in those with high‐grade injury .…”

Section: Discussionmentioning

confidence: 98%

Management of paediatric high‐grade blunt renal trauma: a 10‐year single‐centre UK experience

et al. 2018

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“…A three-year prospective study is underway, as these children are at risk if they continue to have untreated hypertension. 13 Patients who do not present with hypertension during the initial three to four weeks post-trauma, are highly unlikely to develop hypertension after this time period. 14 None of the children reviewed at our institution developed post-injury hypertension with the caveat that while all patients were seen in clinic for follow-up, not all patients had follow-up as far out as one month.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Blunt Renal Trauma. A Single Institution’s 20 Years Experience with Surgically Treated Patients.

Karavdić

2020

AJTES

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Background: Kidney is the most common site of genitourinary trauma. 50% of all urinary injuries is kidney.Kidney is also affected in 8-12% of all blunt and penetrating trauma to abdomen. 80-90% of renal injury is caused by blunt injury GY. Children, compared to adults, have at a higher risk of renal injury from blunt trauma due to a variety of anatomic factors including decreased perirenal fat, weaker abdominal muscles, and a less ossified thoracic cage. While there are strong trends toward non-operative management of blunt renal trauma, there are no explicit guidelines for high grade injuries. Organ preservation in children is always a primary goal with solid organ injury. Aim of the work: The aim of the retrospective study is to show the specificity of kidney injury in children as well as the specificity of surgical treatment. Material and Methods: All 19 patients under the age of 18 who were admitted to Clinic for Pediatic surgery in Sarajevo with a diagnosis of renal trauma were retrospectively reviewed .The Echo an CT were used to identify patients with a renal injury. The time period examined was between January 1, 1999- 2019. Inclusion criteria were either a diagnosis of renal trauma or a diagnosis of blunt abdominal trauma and hematuria. Exclusion criterion was death due to an additional traumatic injury. The mechanism of injury (fall, car accident , assault) injury grade (I-V), the presence of hematuria, and demographic data to include age, weight, and sex, were recorded and reviewed. In addition, amount of blood product required, hematocrit nadir prior to transfusion to assist in ascertaining whether transfusion was necessary, surgical interventions performed, and hospital length of stay were also retrospectively analyzed. Due to the low sample size we used descriptive as opposed to inferential statistics in our analysis. Result: Demographics include male to female ratio of 13:6 and the average age of patients was 11.9 + 4.6 years. Of the nineteen patients who underwent review, eleven (57,89%) children presented with a grade III renal injury, five with a grade IV injury and three with grade V injury. Six patients presented with gross hematuria and 3 with microscopic hematuria. Only four patients (22%) required blood transfusions, with the average hematocrit nadir being 31 + 5.3% (24.8-37.8). One of the two patients transfused had a concomitant grade IV splenic laceration with a hematocrit nadir of 24.8% and clinical symptoms consistent with shock. Conclusions:The specificity of the child's anatomy is an aggravating prognostic factor (the kidney is larger in relation to the body cavity than in adults, less protected against the ribs, the muscles of the body and the lower abdomen, the less developed peritoneal and retroperitoneal fatty tissue).It is recommended to initiate conservative treatment (leaching, infusion solution, monitoring) and possibly delayed surgical treatment.Indications for early surgicaly treatment are reserved only for patients with bleeding (absolute) and extravasation (relative).If it is necessary surgical treatment sould be maximally preserve kidney tissue.

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The incidence of long-term hypertension in children after high-grade renal trauma

Cited by 16 publications

References 12 publications

Kidney and uro-trauma: WSES-AAST guidelines

Kidney and uro-trauma: WSES-AAST guidelines

Management of paediatric high‐grade blunt renal trauma: a 10‐year single‐centre UK experience

Pediatric Blunt Renal Trauma. A Single Institution’s 20 Years Experience with Surgically Treated Patients.

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