The aim of the study was to determine the risk factors relating to conservative surgery outcome of blunt renal trauma. The rate of surgery was 43.2 percent. Early intervention surgery in 2411 after get into hospital is 76.7 percent. Tne rate of success of renal conservation surgery is 83.6 percent. Preoperatively and operatively severe grading of renal trauma (IV-V) were the highest risk of nephrectomy, statistically significant with OR = 7.990 (p = 0.009) and OR = 14.943 (p = 0.008) respectively. Shock condition and intra-abdominal trauma are the most dangerous factors which effect on circulation disorder in operating with p = 0.001 and 0.007. Operative hemodynamic instability was the highest risk factors of severely postoperative progression with statistically significance (OR = 6.058, P = 0.009). Preoperative renal dysfunction and postoperative hemodynamic instability were 2 risk factor highest leading to postoperative renal dysfunction with 6.429 (p = 0.001) and 13.333 (p = 0.007). The rate of postoperative bleeding is 6.9 percent and 6 percent cases presented with prolonged urine leakage. In conclusion, AAST based grading system in renal trauma is the most important predictive factor that need to specify surgery after renal injury. Early intervention indication before 24h increase the possibility of renal conservation and decreased the rate of complication and long term outcome. Severe grading of renal trauma were the highest risk of nephrectomy.