Show AllChildren with renal injuries may have bruising, pain in their back, or there may be no marks at all. If renal injury is suspected, your child will be given a physical examination. A urinalysis (urine test) will test if there is blood in the urine. X-rays, CAT scan (a picture with more detail than an x-ray), and Ultrasound (special test that shows pictures of the kidney), or blood tests may be done to determine how badly your child's kidney is damaged.
Kidney injuries are graded based upon the information received from testing. Grade 1 kidney injuries are the smallest, while Grade 5 injuries are the biggest.
Most kidney injuries do not require surgery. The child with a small injury to the kidney will go to the general care unit for a few days of strict bed rest. Children with major kidney injuries may go to the ICU (Intensive Care Unit) for a day or two on strict bed rest and then to the general care unit. The urologist (kidney doctor) may also be caring for your child when the injury to the kidney is bad.
Decreasing the amount of bed rest and increasing the child's activity level will happen gradually as the child's injury heals. Each child is different in the time it takes them to heal.
If the child's kidney is badly damaged, surgery may be needed to fix the damage and to stop the bleeding. The surgical incision may be closed with small metal staples or stitches. The child may need some extra blood before or after surgery. He / she will also not be allowed to eat right away. However, he /she will receive fluids through an IV (a small tube in their vein). The child will be closely cared for in the ICU after surgery for a few days for any bleeding, pain, or infection. The child is then transferred to the general care unit as healing continues.
After you leave the hospital, your child will need to be watched for any problems. Complications do not happen very often but as a precaution, you should be able to recognize warning signs and symptoms. You will need to call your doctor right away if you see any blood in the urine, fever greater than 100.5 degrees, or belly pain and tenderness.
Speak to your health care provider about medications your child has previously taken. Your child may have some pain or soreness at home. Give
acetaminophen (also known as Tylenol
") for pain. Your child's doctor may write a prescription for stronger pain medication. Give the prescription if the pain does not go away one hour after giving acetaminophen. Follow the directions on the bottle. However, do not give your child
ibuprofen (also known as Motrin
", Advil
", Aleve
", etc.) until the doctor says that it is okay.
Your child may shower or take a bath, but he / she may need help for several days after going home. Check with your doctor about taking baths if your child has had surgery.
If your child has cuts or scrapes on the skin from other injuries, wash the areas with warm, soapy water and pat dry. If your child has stitches or staples, follow the specific instructions for caring for them.
After the injury, your child may be tired and irritable. It takes time to heal. Use this time for rest and quiet activities. Tell your child that he / she will feel better soon. Have your child play board games, read, or do small craft projects for short periods of time. Infants and toddlers are harder to distract and will be more difficult to confine. Try putting your infant or toddler in a large crib or playpen. Ask family and friends to visit, but for short periods of time and not at the same time to minimize activity.
It is very important to teach your child about all types of safety. Your child watches you and will tend to do what you do. You should always practice proper safety precautions. Your child should learn to wear a helmet when riding a bike, rollerblading or skate boarding. You should also teach your child to always wear a seatbelt when riding in a car. Remember that children 12 years and younger should wear correct safety restraints in the back seat when the car has a passenger side airbag.
All children with kidney injuries are seen in either the Trauma / Surgery or Urology Clinics about 2 weeks after they leave the hospital. Your doctor will decide then whether or not your child will need follow-up testing. Your child may need a pediatrician to watch their blood pressure.
Your child may not feel like eating regular foods right away, but it is important to eat a balanced diet and drink as much fluid as before he / she was hurt.
Plan quiet activities for the first several days at home. Your child does not need to stay in bed, but should walk and play quietly. Your child should not play rough with family, friends, or pets. He / she should not participate in any activities or sports that involve jumping, climbing, or running such as bike riding, in-line skating, dance, gymnastics, football, basketball, soccer or track. Activities like gym class and contact sports are not allowed for some time after leaving the hospital. Returning to such activities will depend on the grade of injury.
Your child can go back to day care or school usually one to two weeks after the injury. Your nurse or doctor will help you decide when it is time to send your child back to school.
If surgery was needed or your child has other injuries, they may be out of school longer. The trauma team will help you with your child returning to school. At school, your child should not be taking gym class until the doctor says it's okay. It's best for your child to leave class 5 minutes before the other students, to avoid bumping into children in the halls. Your child should not carry or lift more than one to two textbooks at a time, even if they carry a book bag or backpack.
For additional information on this or any Health Topic, please call the Family Resource Center, 513-636-7606, or your pediatrician.
