Abstract: SA-PO1275
What Drives Severity of Spontaneous Renal Hemorrhage? Clinical Predictors and Outcomes
Session Information
- Onconephrology: Epidemiological Trends, Risk Stratification, and Clinical Outcomes
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1600 Onconephrology
Authors
- Carrera, Litzel, Maimonides Medical Center, New York, New York, United States
- Jana, Kundan, Maimonides Medical Center, New York, New York, United States
- Okaka, Enajite I., Maimonides Medical Center, New York, New York, United States
Background
Spontaneous renal hemorrhage (SRH) is an uncommon but potentially life-threatening condition, most often described in case reports. Etiologies include hemorrhagic renal cysts, renal tumors, acquired cystic kidney disease, and spontaneous subcapsular or perirenal hematomas. Clinical predictors of severity and outcomes remain poorly defined.
Methods
We conducted a retrospective observational cohort study of adult patients hospitalized at a tertiary-care center with non-traumatic SRH between January 2012 and October 2024. Demographics, comorbidities, kidney disease status, antithrombotic exposure, laboratory findings, imaging characteristics, management, and outcomes were reviewed. The primary outcome was admission hemoglobin level. The secondary outcome was prolonged hospitalization, defined as length of stay > 3 days. Univariate comparisons used the Mann-Whitney U test and Fisher’s exact test.
Results
Seventeen patients were included. Mean age was 63.8 ± 17.8 years, 58.8% were male. Hypertension was the most common comorbidity (76.5%), followed by CKD (29.4%), diabetes mellitus (23.5%), and nephrolithiasis (29.4%). Hemorrhagic renal cysts were the most common radiographic finding (52.9%), followed by renal mass-associated hemorrhage (23.5%) and perinephric or retroperitoneal hematoma (23.5%). All patients underwent CT imaging. Mean admission hemoglobin was 10.4 ± 2.4 g/dL, and mean serum creatinine was 2.5 ± 2.9 mg/dL, reflecting substantial baseline renal impairment in this cohort. Management was invasive in most patients, including surgery (41.2%) and interventional radiology or image-guided drainage (29.4%). Patients with CKD had lower admission hemoglobin than those without (8.3 ± 1.7 vs. 11.5 ± 2.0 g/dL; p = 0.008). Gross hematuria was associated with prolonged hospitalization, occurring in all 6 patients with hematuria compared with 3 of 11 without (100% vs. 27%; p = 0.009).
Conclusion
SRH is a heterogeneous condition that frequently occurs in patients with significant baseline comorbidity. CKD was associated with lower admission hemoglobin, suggesting that impaired renal function may be linked to more severe hemorrhagic presentations. Gross hematuria was strongly associated with prolonged hospitalization and may serve as a clinically accessible marker of disease course. These findings are limited by a small sample size and should be interpreted as hypothesis-generating.