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5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
Published on: July 3, 2013
Does nephrectomy for trauma increase the risk of renal failure?
George C Velmahos1, Constantinos Constantinou, George Gkiokas
1Department of Surgery, Division of Trauma and Critical Care, Los Angeles County and University of Southern California Medical Center, 1200 N. State Street, Los Angeles, California 90033, USA. gvelmahos@partners.org
World Journal of Surgery
|September 2, 2005
Summary
Nephrectomy (kidney removal) in trauma patients does not increase the risk of renal failure compared to nephrorrhaphy (kidney repair). Kidney salvage may not offer significant postoperative renal function benefits.
Area of Science:
- Trauma Surgery
- Nephrology
- Surgical Outcomes
Background:
- Renal failure is a significant complication after severe trauma surgery.
- Kidney injuries can be managed by nephrectomy or nephrorrhaphy.
- Nephrectomy might increase renal failure risk in vulnerable trauma patients.
Purpose of the Study:
- To compare the rates of renal function compromise and renal replacement therapy between trauma patients undergoing nephrectomy versus nephrorrhaphy.
- To evaluate the clinical benefit of kidney salvage in severe trauma.
Main Methods:
- A prospectively collected trauma database was used.
- 59 patients with nephrectomy were matched 1:1 with 59 patients with nephrorrhaphy.
- Matching criteria included age, Injury Severity Score, abdominal Abbreviated Injury Score, and injury mechanism.
Main Results:
- No significant differences were observed in renal function compromise (10% vs. 14%, p=0.57) between the groups.
- Rates of renal replacement therapy (5% vs. 0%, p=0.12), hospital stay, and mortality were similar.
- Salvaging the injured kidney did not demonstrate a clear clinical advantage for postoperative renal function.
Conclusions:
- Nephrectomy in trauma patients is not associated with increased renal failure risk compared to nephrorrhaphy.
- Given operative complexity, nephrectomy should not be avoided when indicated in severe trauma.
- Kidney salvage may not offer significant postoperative renal function benefits.
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