Elbaset MA, Abouelkheir RT, El-Baz R, et al. - Researchers conducted a retrospective analysis of patients with isolated blunt high grade renal trauma (HGRT; renal trauma grade ≥ IV) in order to determine the predictors for conservative management failure and long term outcomes after isolated blunt HGRT. Of 63 included patients [mean (SD) age: 35.1 (16.6) years], 39 patients (62%) had successful conservative management, while active bleeding control was needed in 16 and 8 patients who underwent TAE and surgical exploration, respectively. Overall findings suggest that conservative management can be successfully and safely performed in blunt HGRT. Increased hematoma rim distance (HRD) and presence of vascular contrast extravasation (VCE) appeared to be reflective of the severity of the renal injury. Indicators for active treatment are laceration number and renal devascularization. Decrease in ipsilateral renal parenchymal volume (RPV) was observed with contralateral compensatory RPV rise. In addition, parenchymal devascularization was an indicator for RPV decrease.