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Introduction:
Renal injury occurs in up to 10% of blunt force injuries. Rural populations have a higher rate of trauma and are 50% more likely to suffer a trauma related death than their urban counterparts. We reviewed the mechanism of injury, management and outcomes of patient admitted with renal injury at a single rural level 1 trauma center . We hypothesize that the mechanisms of injury and the outcomes are different than in published urban data.

Materials & Methods:
After institutional review board approval we retrospectively reviewed the charts of all adult patients (>19 years of age) admitted from 2006-2010 with renal trauma. Variables evaluated included age, gender, intoxication status, grade, mechanism of injury, and associated abdominal injuries. Management and outcomes were analyzed.

Results:
Of the 104 patients admitted 80 (77%) were male and 24 (23%) female. Mean age was 44 years. Blunt force trauma accounted for the majority of injuries (98%). The most common mechanism of injury was motor vehicle collision(MVC) 36/104(35%), followed by recreation related activities 35/104 (34%), falls (16%), and motor cycle crash 17/104(16%). Winter related activities accounted for 19/24 (79%) of recreational injuries. Five patients (6%) required embolization and one required emergent nephrectomy. Mortality was 8/104(8%). MVC resulted in significantly more multiple intra-abdominal injuries (64% vs 29%, p=0.0173).

Conclusions:
Unlike urban setting, our data from a rural center shows that recreational renal injuries were as common as MVCs. MVCs were found to result in significantly more multi organ injuries. Management of renal trauma remains mostly nonoperative.