Altuve left Tuesday's game after racing toward home on a Michael Brantley sacrifice fly in the fourth inning. He decided not to slide, instead electing to take the plate standing up.
But when Royals catcher Meibrys Viloria made contact with Altuve, the Astros star tripped and landed awkward in the grass.
Altuve stayed down briefly, then walked off the field on his own power.
He did not return to the game, in which the Astros thoroughly dominated both with and without Altuve.
The Astros open the regular season Friday with a four-game home stint against the Seattle Mariners.