espanolOBJETIVO: Caracterizar la condicion clinica, el tipo de abordaje terapeutico y desenlaces de pacientes con trauma renal de alto grado (AAST: 4 y 5) atendidos en un hospital de tercer nivel. Cali, Colombia. METODOS: Se realizo un estudio observacional descriptivo con pacientes mayores de 15 anos atendidos entre el 1 de enero de 2015 y el 1 enero de 2019, con diagnostico de traumatismo renal y traumatismo de vasos renales. Se recolectaron variables demograficas, clinicas y de severidad del trauma. Se realizo un analisis univariado con tablas de frecuencia, medidas de tendencia central, dependiendo de tipo de intervencion, lesiones asociadas, uso de hemoderivados e indices de severidad. RESULTADOS: Se analizaron 71 historias clinicas, 82% de sexo masculino, el promedio de edad fue 25 anos (rango: 15-55). Respecto al grado trauma renal, el 69%de los pacientes fueron grado IV y el 31% grado V. Las lesiones penetrantes se vieron en un 87% vs 13% delesiones por mecanismo contuso (no penetrante). El 54% de los pacientes fueron puntuados con un Indice de Severidadde Trauma >= 25 y el 51% de los pacientes presento un Indice de Trauma Abdominal CONCLUSIONES: El traumatismo renal de alto grado es una condicion clinica frecuente en pacientes masculinos entre la segunda y tercera decada de vida, en nuestro medio la mayoria corresponden a traumas penetrantes. La mayoria de casos fueron manejados con algun procedimiento quirurgico, sin embargo, con un importante porcentaje de manejo conservador con tasas de complicaciones menores del 30 %, que cambia el paradigma del tratamiento del trauma renal de alto grado EnglishOBJECTIVE: To characterize the clinical condition, the type of therapeutic approach and outcome of patients with severe renal trauma (AAST: 4 and 5) treated in a tertiary hospital. Cali, ColombiaMETHODS: A descriptive observational study was conducted with patients older than 15 years treated between January 1, 2015 and January 1, 2019, with a diagnosis of renal trauma and renal vessel trauma. Demographic, clinical and trauma severity variables were collected. A univariate analysis was carried out with frequency tables, measures of central tendency, depending on type of intervention, associated lesions, use of blood products and severity indices. RESULTS: 71 medical records were analyzed, 82% male, the average age was 25 years (range: 15-55). Regarding renal traumatic grade, 69% of the patients were grade IV and 31% grade V. Penetrating injuries were seen in 87% versus 13% of injuries due to blunt (non-penetrating) mechanism. 54% of the patients were scored with a trauma severity index >= 25 and 51% of the patients had an abdominal trauma index Surgical management was managed in 67% vs. 32% for non-trauma management. surgical. The hospital stay was 17 days on average and 16.9% had complications. CONCLUSIONS: Severe renal trauma is a frequent clinical condition in male patients between the second and third decade of life, in our environment the majority corresponds to penetrating traumas. Most cases were managed with some surgical procedure, however, with a significant percentage of conservative management with complication rates of less than 30%, which changes the paradigm of treatment of high-grade renal trauma