J Korean Med Sci.  2022 Dec;37(47):e333. 10.3346/jkms.2022.37.e333.

Epidemiology and Management Trend of Renal Trauma: Results of a Nationwide Population-Based Study

• Tae BS
• Jang HA
• Yu J
• Oh KJ
• Moon KH
• Park JY

• KMID: 2536515
• DOI: http://doi.org/10.3346/jkms.2022.37.e333

Abstract

Background
To analyze the incidence of renal trauma using the National Health Insurance Service Database (NHISD).
Methods
Using the NHISD, representative of all upper urinary tract injuries in Korea, data regarding renal trauma were analyzed. The International Classification of Diseases, Tenth Revision Clinical Modification codes were used to identify the diagnoses. The incidence estimates of renal traumas were analyzed using Poisson regression analysis. Risk factors for high-grade renal trauma were estimated using multivariable logistic regression analyses.
Results
Patients with renal trauma were identified from a nationwide database collected by the National Health Insurance Service of Korea between 2012 and 2016. Among 37,683 individuals with renal trauma, 1,293 (3.4%) were diagnosed with high-grade renal trauma. Surgical therapy was performed in 995 (2.6%) patients with renal trauma and 184 (14.2%) patients with high-grade renal trauma. Renal trauma occurred in all age groups, and the ratio between men and women was approximately 3:1. Men and women experienced 8,000 (31.82/100,000) and 2,365 (9.52/100,000) renal trauma in 2013 (total 10,365, 20.73/100,000) and 5,243 (20.56/100.000) and 2,168 (8.58/100,000) in 2016 (total 7,411, 14.60/100,000), respectively. In multivariable analysis, female sex, age (age; 41–60 and 61–80 years), and comorbidity of peripheral vascular disease, renal disease, and malignancy were revealed as risk factors for high-grade renal trauma.
Conclusion
Annual incidence of renal trauma is 17.33 per 100,000 population from 2012 to 2016. The incidence of kidney damage decreased gradually from 2013 to 2016, and the majority of renal trauma cases were low-grade. Conservative management was the preferred treatment modality in most patients with renal trauma, including those with high-grade renal trauma.

Keyword

Kidney; Trauma; Epidemiology; Korea

Figure

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  Fig. 1 Annual incidence of renal trauma of Korea. The annual incidence of renal trauma has a trend of decreasing (Poisson regression; HR, 0.983; 95% CI, 0.976–0.989; P < 0.001). Risk of renal trauma in men is higher than women (Poisson regression; HR, 2.925; 95% CI, 2.862–2.989; P < 0.001).HR = hazard ratio, CI = confidence interval.

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  Fig. 2 Trends in the management of renal trauma between 2012 and 2016.

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  Fig. 3 Organs affected by trauma. (A) There was a higher incidence of concomitant other site injuries (high grade 53.9% vs low grade 34.3%, P < 0.001). (B) Proportion of concomitant other site injuries in low-grade renal trauma. (C) Proportion of concomitant other site injuries in high-grade renal trauma.

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