Embolization Shows Favorable Results in High-Grade Kidney Injuries

September 29, 2026—The Society of Interventional Radiology (SIR) announced the publication of a study demonstrating that embolization greatly reduces the risk of acute kidney injury and in-hospital mortality compared to nephrectomy when treating initially stable trauma patients with high-grade kidney injuries. The study was published online Waseem Wahood, MD, et al in Journal of Vascular and Interventional Radiology.

According to SIR, the analysis examined 849 cases of American Association for the Surgery of Trauma grade III-V kidney injuries recorded in the American College of Surgeons-Trauma Quality Improvement Program national trauma patient registry between 2017 and 2022. Of those cases examined, 380 (44.8%) patients underwent nephrectomy and 469 (55.2%) patients underwent embolization.

SIR reported that nephrectomy compared to embolization was associated with a higher risk of in-hospital mortality (17.1% vs 4.9%) and acute kidney injury (14.7% vs 4.1%).

In addition, nephrectomy was associated with significantly higher rates of cardiac arrest with cardiopulmonary resuscitation (8.5% vs 2.3%), unplanned return to the operating room (12.1% vs 4.0%), severe sepsis (2.6% vs 0.9%), myocardial infarction (1.0% vs 0.0%), deep surgical site infection (1.5% vs 0.2%), and superficial incisional surgical site infection (1.6% vs 0.2%).

“Our findings show that embolization is safe, effective and associated with better outcomes than nephrectomy for this patient cohort in both the near and long term,” commented Dr. Wahood in the SIR press release. “By reducing the risks of acute kidney injury, embolization may help avoid chronic illness for these patients.”

Dr. Wahood continued, “While additional prospective work is needed to validate these findings, our initial analysis demonstrates that a renal-preservation strategy with embolization should be considered for initial management of stable patients with high-grade renal trauma.”