# Kidney contusion - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care ## Treatment metadata - No drug therapy in primary care (Referral & Advice) ## Complete treatment card ```text KIDNEY CONTUSION 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 Review status: REVIEWED against the source listed above (2026-08) 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 Source StatPearls "Kidney Trauma" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE) [1st line] Adult 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 Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. Source No dose - referral pathway, no medicine given in primary care Why 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. Caution 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. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)