Renal artery embolization in patients with blunt renal trauma: Evaluating the efficacy of the procedure and the impacts on renal function and blood pressure - A retrospective case series study

To evaluate the impact of renal artery embolization (RAE) on renal function and blood pressure (BP) in patients with blunt renal trauma (BRT). This retrospective study was approved by institution review board of a level I trauma center. Over an 8-year period, 64 patients with BRT underwent RAE. The measurements of renal function and BP were obtained at admission, and followed up for the duration between 4 days and 12 months. Patients who died during hospitalization were excluded from the renal function and BP analysis. Variables were recorded and analyzed using uni-and-multivariate tests. Binary logistic regression was used to compute the predictive factors for mortality. Technical success (complete occlusion of the vascular lesions) rate was 96.9% (n = 62), clinical success (keeping alive and complete cessation of bleeding without the need for further procedure) rate was 85.9% (n = 55), and mortality rate was 9.4% (n = 6). Predictive factors of age ≥ 60 years (OR = 10.1, p = 0.023) and multiple-organ-injury (≥ 2 organs in addition to kidney; OR = 8.7, p = 0.015) were significant for mortality. The value of AUROC (Area under the Receiver Operating Characteristic Curve) was 0.887 indicating that the model has excellent accuracy. Forty-four patients (n = 44, 68.8%) had renal-related complications, in which, thirty-seven (n = 37, 84.1%) resolved after conservative treatment. Renal function analysis showed significant improvements in serum creatinine, eGFR (MDRD formula) and renal function stage (National Kidney Foundation) after RAE (p < 0.001). BP analysis showed significant elevation in diastolic BP (p = 0.017) and mean arterial pressure (p = 0.018) after RAE. The number of patients with normal BP (stages 2 and 3) was significantly increased after RAE (p < 0.001). RAE is the treatment of choice for patients with severe renal trauma because of its high technical and clinical success rates. RAE, with discretion, can preserve renal function and restore normal BP after the procedure.