Renal trauma: evaluation, management, and return to play

Renal injuries can occur in sports participation by both traumatic and atraumatic mechanisms. Atraumatic injury includes exercise-induced proteinuria, which is seen in intense exercise and usually resolves quickly without kidney damage. Exercise-induced hematuria typically resolves within 24-48 h without need for further investigation. Traumatic kidney injuries occur as a result of blunt abdominal trauma, flank trauma, or penetrating injury. Microscopic hematuria is the most common finding in these situations. In the absence of associated hypotension, or without macroscopic hematuria, further imaging rarely is needed. The American Association for the Surgery of Trauma (AAST) organ injury severity scale for the kidney is a useful and validated tool to determine who is likely to require further work-up and surgery. The athlete with the solitary kidney appears to have low risk for kidney loss with participation in both contact and noncontact sports.