chronic

Kidney contusion

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class UD35.00 - condition scope only, no dose · Kidney Trauma - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK532896/ · No dose - referral pathway, no medicine given in primary care

Verified against1 document

No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (2)

Any blunt or penetrating injury to chest, abdomen or pelvis carries a raised risk of kidney damage
Someone with an already abnormal kidney can sustain serious damage from minor trauma, so the history matters

Signs — what you find (5)

Suspect it strongly with tenderness, pain, a palpable mass or bruising over the flank, abdomen or back [bruising]
Blood in the urine raises the suspicion but is often absent, especially when there are many injuries [blood in the urine]
A stab at the front axillary line threatens the renal hilum with its vessels, nerves and ureter; one at the back axillary line more often tears the kidney tissue
Bullet paths are unpredictable: entry and exit points raise suspicion but the kidney may be untouched
The chest, abdomen, flank and genital area all need careful examination

Tests (12)

Take the usual trauma bloods, full count, metabolic panel, clotting and lactate, along with a urine sample
Blood in urine is commoner after blunt than penetrating injury and is more often microscopic than visible
How much blood is in the urine, or whether there is any, does not predict how bad the injury is
Contrast CT with immediate and delayed pictures is the study of choice, the phases separating leaking urine from active bleeding
CT maps the damage as surgery would show it, and a blush of contrast indicates active leakage
FAST scanning in the trauma bay looks for fluid in the abdomen or around the heart, which points to bleeding
FAST depends on who is scanning and is poor at retroperitoneal bleeding and at minor kidney injury
Stable patients who respond to resuscitation go on to contrast CT, and a negative scan still does not exclude kidney injury
If instability forces immediate surgery, urography on the table shows whether the other kidney works
Image the kidney after blunt abdominal trauma with visible or microscopic blood in the urine, or with unstable circulation
Also image penetrating wounds of chest, abdomen, flank or back whose track could cross a kidney
And image on mechanism alone: displaced ribs beside the kidney, a high-speed crash, or a fall from height

If not this — what else fits (10)

Acute tubular necrosis
Azotaemia
Chronic kidney disease
Acute glomerulonephritis
Haemolytic uraemic syndrome
Henoch-Schonlein purpura
High serum potassium
High serum magnesium
High serum sodium
Hypertensive emergency

SourceStatPearls "Kidney Trauma" - disease-level clinical article

Presentation findings are traced to the source above.

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line

Adult dose and duration

Blunt renal trauma (from road traffic accidents, falls, or assault) needs urgent assessment for internal bleeding; the GP recognises and refers for imaging, with simple analgesia while arranging transfer. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Cautions

Flank pain with blood in the urine after trauma, low blood pressure, or signs of ongoing bleeding require emergency referral.
No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.