| Classification | Description | Notes |
| Grade 1 | – Subcapsular hematoma and/or parenchymal contusion without laceration | |
| Grade 2 | – Perirenal hematoma confined to Gerota fascia
– Renal parenchymal laceration ≤1 cm depth without urinary extravasation |
|
| Grade 3 | – Renal parenchymal laceration >1 cm depth without collecting system rupture or urinary extravasation
– Any injury in the presence of a kidney vascular injury or active bleeding contained within Gerota fascia |
|
| Grade 4 | – Parenchymal laceration extending into urinary\ collecting system with urinary extravasation
– Renal pelvis laceration and/or complete ureteropelvic disruption – Segmental renal vein or artery injury – Active bleeding beyond Gerota fascia into the retroperitoneum or peritoneum – Segmental or complete kidney infarction(s) due to vessel thrombosis without active bleeding |
|
| Grade 5 | – Main renal artery or vein laceration or avulsion of hilum
– Devascularized kidney with active bleeding – Shattered kidney with loss of identifiable parenchymal renal anatomy |
Note: Advance one grade for bilateral injuries up to grade 3.
Reference:
Kozar RA et al. (2018). Organ injury scaling 2018 update: Spleen, liver, and kidney. J Trauma Acute Care Surg; 85(6):1119- 1122