Nyreskader

Nyreskader, or kidney injuries, refer to damage affecting one or both kidneys. They can be traumatic, resulting from blunt or penetrating trauma, or non-traumatic, presenting as acute kidney injury (AKI) from illness, dehydration, sepsis, or nephrotoxic exposure.

Traumatic injuries are commonly caused by vehicle crashes, falls, or penetrating wounds. They are graded from I to V by the American Association for the Surgery of Trauma (AAST), with higher grades reflecting greater tissue damage and possible collecting-system or vascular injury. Symptoms may include flank or abdominal pain, tenderness, visible or microscopic blood in the urine, decreased urine output, and signs of shock in severe cases.

Diagnosis typically starts with physical examination and urinalysis. Imaging usually involves ultrasound as a rapid initial modality, followed by contrast-enhanced CT to define the injury and guide management, provided the patient is hemodynamically stable.

Management emphasizes stabilization of circulation and kidney perfusion. Low-grade injuries (I–II) are often managed non-operatively with observation and analgesia. Higher-grade injuries (III–V) require closer monitoring and may need interventional procedures such as ureteral stenting, percutaneous drainage, nephrostomy, or surgery for uncontrolled bleeding or urinary extravasation.

Non-traumatic nyreskader refer to AKI and related kidney dysfunction from systemic illness, dehydration, sepsis, or nephrotoxins. Treatment focuses on treating the underlying cause, maintaining perfusion and electrolytes, avoiding further nephrotoxins, and, if needed, renal replacement therapy.

Prognosis varies by injury severity, but many low-grade traumas recover fully. Follow-up assessment of renal function is often recommended after discharge.