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Kidney organ injury scaling: 2025 update
Sorena Keihani1, Gail T Tominaga, Rano Matta
1From the Division of Urology, Department of Surgery (S.K., J.B.M.), University of Utah School of Medicine, Salt Lake City, Utah; Department of Surgery (G.T.T.), Scripps Memorial Hospital La Jolla, La Jolla, California; Division of Urology, Department of Surgery (R.M.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology (J.A.G.), University of Washington, Harborview Medical Center, Seattle, Washington; Department of Surgery (C.C.), UC Health Medical Center of the Rockies, Loveland, Colorado; Department of Surgery (K.L.K.), University of California San Francisco Fresno, Fresno, California; Department of Surgery (M.C.), Case Western Reserve University, Cleveland, Ohio; Shock Trauma Center (R.A.K.), University of Maryland School of Medicine, Baltimore, Maryland; Division of Acute Care and Regional General Surgery (N.L.W., B.L.Z.), University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin; and Scott Department of Urology (M.C.), Baylor College of Medicine, Houston, Texas.
The American Association for the Surgery of Trauma updated its kidney organ injury scale based on new evidence and multidisciplinary consensus. This revision reflects modern diagnostic and management practices for renal trauma.
Area of Science:
- Trauma Surgery
- Urology
- Radiology
Background:
- The American Association for the Surgery of Trauma (AAST) first published kidney organ injury scaling in 1989.
- Previous updates occurred, with the last in 2018.
Purpose of the Study:
- To present the updated AAST kidney organ injury scale.
- Incorporate the latest evidence in diagnosis and management of renal trauma.
- Reflect multidisciplinary consensus on renal trauma care.
Main Methods:
- Multidisciplinary consensus development.
- Review of current evidence in renal trauma diagnosis and management.
- Incorporation of updated imaging and treatment protocols.
Main Results:
- The updated scale reflects near-universal use of computed tomography (CT) for renal trauma evaluation.
- The scale acknowledges widespread adoption of conservative management for all grades of renal trauma.
- Revised guidelines provide a contemporary framework for assessing and managing kidney injuries.
Conclusions:
- The updated AAST kidney organ injury scale represents a significant revision based on current practices.
- This consensus-driven update aligns with advancements in imaging and the trend towards conservative management.
- The revised scale aims to standardize and improve the care of patients with renal trauma.
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