Health Library

Kidney Injuries

What Are the Symptoms of a Kidney Injury?

Children with a kidney injury may have bruising, pain in their back, blood in their urine, or abdominal pain after the trauma.

What Causes a Kidney Injury?

A kidney injury can happen after a car crash, fall, bike wreck, or any activity that causes a hard blow to the abdomen or back. A penetrating kidney injury can be caused by a gunshot, knife, or other sharp object that cuts or tears the kidney.

How Is a Kidney Injury Diagnosed?

If a kidney injury is suspected, the trauma surgery providers will thoroughly and carefully examine your child. A urinalysis (urine test) will test if there is blood in the urine. X-rays, a computed tomography (CT) scan, ultrasound or blood tests may be done.

The American Association for the Surgery of Trauma (AAST) grades kidney injuries on a scale of 1-5. The grade is determined by the size and location of the injury in the kidney seen on a CT scan. Grade 1 is the least severe and 5 is the most severe.

How Is a Kidney Injury Treated?

Children with grades 1 - 2 kidney injuries may be discharged from the Emergency Department or admitted to the hospital. Children with grades 3-5 kidney injuries may be admitted to the general care unit or to the intensive care unit (ICU). Most kidney injuries are treated without surgery. Depending on the grade of injury, treatment can include strict bed rest, nothing to eat or drink for a short period of time, pain control, lab work, and IV fluid hydration. Sometimes blood transfusions are necessary. A urologist (urinary system doctor) may also be consulted to help care for your child.

For a large kidney injury, sometimes surgery is needed to stop urine from leaking or to stop bleeding.

If your child has surgery, they will not be allowed to eat after surgery for some time. However, they will be given an IV (a small tube in their vein) for fluid hydration. They may also have a nasogastric tube (a tube placed through the nose into the stomach) after surgery to keep their stomach empty.

Medications and Pain Management

Speak to your trauma surgery provider about medications your child was taking before they were admitted to the hospital. They will let you know when it is okay to restart any home medications. Your child may have some pain or soreness at home.

Give acetaminophen (Tylenol^®) for pain. Your child's trauma surgery provider may also write a prescription for stronger pain medication. Give the stronger medication if the pain does not go away one hour after giving acetaminophen. Follow the directions on the prescription.

Do not give your child NSAIDs or ibuprofen (Motrin^®, Advil^®, Aleve^®, etc.) until the trauma surgery provider says that it is okay. Your child may require a stool softener while taking prescription pain medication to prevent constipation and straining with bowel movements.

Wound and Skin Care

Your child may shower or take a bath, but they may need help for several days after going home.

If your child has had surgery, check with your trauma surgery provider about taking a shower or bath. Follow instructions given by your trauma surgery provider regarding any other injuries or wounds.

Recovery From a Kidney Injury

Activity After a Kidney Injury

Your child does not need to stay in bed but should walk and play quietly while they heal. They may return to school in two to seven days, but your child will be on strict activity restrictions for some time. Strict activity restrictions include no gym, running, activities with wheels, or any activity in which both feet leave the ground at the same time. Your child should not participate in any competitive/contact sports until the activity restriction time period is complete. The length of activity restrictions will depend on the grade of the kidney injury.

Returning to Daycare or School

Your child may require some time off school to be at home to rest. Your trauma surgery provider will give you recommendations regarding going back to school. If surgery was needed or your child has other injuries, they may be out of school longer. At school, your child should not play sports, go to recess, or take gym class until the activity restriction time period is complete.

Emotional Recovery

After the injury, your child may be tired and irritable. It takes time to heal. Use this time for rest and quiet activities. 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 but avoid high-risk activities such as wheeled activities or jungle gyms.

After any trauma, children may experience acute stress symptoms. If you notice your child having nightmares, flashbacks, nervousness, irritability or any other concerning emotional symptoms, please speak with the trauma surgery provider. Short-term therapy can be provided to help children heal and recover emotionally after a trauma.

When to Call Your Trauma Surgery Provider

Call the trauma clinic or seek medical attention if your child has:

• Increased or worsening abdominal pain
• Fever higher than 100.5°
• Difficulty with bowel movements
• Shortness of breath
• Nausea / vomiting
• Dizziness
• A fast heart rate
• Redness, swelling, pus drainage, or increased pain around the wound

How Can I Prevent Kidney Injury?

Preventive Action

It’s important to teach your child about all types of safety. Unintentional injury is one of the leading causes of death for children in the United States.

At Home: If you have guns in the home, they should be unloaded and locked with a locking device with ammunition stored separately.

At Play: Make sure your child wears the correct type of helmet when riding a bike, using other wheeled toys, or taking part in sports that require helmets.

On the Go: Make sure your child is secured in an age-appropriate child restraint every time they ride in a vehicle. Children under 13 years should not ride in the front seat.