“Shock kidney-like Appearance”: Objective evaluation of renal color changes in hemorrhagic shock deaths

•“Shock kidney-like appearance” was defined and evaluated objectively.•The kidney cortex was less reddish than the medulla in the hemorrhage group.•The cutoff value for “shock kidney-like appearance” is Δa* = −1.33. Severe bleeding due to various traumatic injuries can cause hemorrhagic shock, which is difficult to diagnose using forensic medicine. Therefore, we defined the difference in color between the renal cortex and medulla observed in hemorrhagic shock deaths as “shock kidney-like appearance (SKLA)” and digitally analyzed the color difference with a digital camera and color analysis software. The aim of this study was to develop and evaluate a method for objectively determining SKLA and improve the accuracy of forensic diagnosis. We examined the kidneys of 122 cases (83 males and 39 females; average age, 64.8 years) autopsied at our facility. Using Image J, we analyzed the color of the cortex and medulla from photographs of bisected kidneys. We defined the color difference between the cortex and medulla in the L*a*b* color space as cortical-medullary color difference and performed a comparative analysis between the hemorrhage and control groups. Significant differences were observed in ΔL* and Δa* values between the two groups (p