[Report of experiences with therapy of blunt kidney injuries].

Blunt renal injuries are classified into 4 groups, namely contusions (grade I), lacerations (grade II), severe fractures (grade III) and pedicle injuries (grade IV). A group of 71 patients with closed renal trauma is reported being classified into 46 grade I, 20 grade II, 3 grade III and 2 grade IV cases. Only the 5 patients with grade III and IV injuries needed surgical intervention resulting in nephrectomy in all 5 cases. Late complications occurred in 4 of the 20 patients of group II, namely contracted kidneys in 2 and hypertension in another 2 instances. The appropriate treatment should be chosen on an individual basis. In grade III and IV renal trauma, surgical intervention is generally required resulting in most instances in nephrectomy. In grade I lesions expectant management is considered the rule. Controversy exists regarding the optimal therapy of grade II injuries. Statistics demonstrate that surgical intervention in these cases will result in greater renal tissue loss as compared with expectant management.