Cardiorespiratory fitness and sports activities in children and adolescents with solitary functioning kidney

Tancredi, Giancarlo; Lambiase, Caterina; Favoriti, Alessandra; Ricupito, Francesca; Paoli, Sara; Duse, Marzia; Castro, Giovanna De; Zicari, Anna Maria; Vitaliti, Giovanna; Falsaperla, Raffaele; Lubrano, Riccardo

doi:10.1186/s13052-016-0255-6

Cited by 8 publications

(4 citation statements)

References 34 publications

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“…As individuals with a SFK have an increased risk of renal injury, sport participation should be stimulated rather than limited. Indeed, a recent study showed increased cardiorespiratory fitness after exercise training in children with a congenital SFK [ 59 ], as expected. In general, sport participation has been shown to reduce glomerular hyperfiltration [ 60 ], a finding which hopefully removes any remaining barrier in supporting a healthy and active lifestyle in individuals with a SFK even before they reach a state of chronic kidney disease (CKD), at which time exercise is again advised [ 61 ].…”

Section: Childhoodsupporting

confidence: 67%

Life with one kidney

Schreuder¹

2017

Pediatr Nephrol

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Life with a solitary functioning kidney (SFK) may be different from that when born with two kidneys. Based on the hyperfiltration hypothesis, a SFK may lead to glomerular damage with hypertension, albuminuria and progression towards end-stage renal disease. As the prognosis of kidney donors was considered to be very good, having a SFK has been considered to be a benign condition. In contrast, our research group has demonstrated that being born with or acquiring a SFK in childhood results in renal injury before adulthood in over 50% of those affected. Most congenital cases will be detected during antenatal ultrasound screening, but up to 38% of cases of unilateral renal agenesis are missed. In about 25–50% of cases of antenatally detected SFK there will be signs of hypertrophy, which could indicate additional nephron formation and is associated with a somewhat reduced risk of renal injury. Additional renal and extrarenal anomalies are frequently detected and may denote a genetic cause for the SFK, even though for the majority of cases no explanation can (yet) be found. The ongoing glomerular hyperfiltration results in renal injury, for which early markers are lacking. Individuals with SFK should avoid obesity and excessive salt intake to limit additional hyperfiltration. As conditions like hypertension, albuminuria and a mildly reduced glomerular filtration rate generally do not result in specific complaints but may pose a threat to long-term health, screening for renal injury in any individual with a SFK would appear to be imperative, starting from infancy. With early treatment, secondary consequences may be diminished, thereby providing the optimal life for anyone born with a SFK.

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Section: Childhoodsupporting

confidence: 67%

Life with one kidney

Schreuder¹

2017

Pediatr Nephrol

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“…Therefore adequate renal protective treatment and blood pressure control in these patients should be promptly instituted [ 28 ]. Moreover, the increase in blood pressure should be also treated with an increase of sport activity; since it tends to improve the cardiorespiratory fitness in children with SFK [ 29 ] and kidney transplantation [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Evolution of blood pressure in children with congenital and acquired solitary functioning kidney

et al. 2017

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BackgroundIt is not yet clear if blood pressure and renal function changes evolve differently in children with a congenital or acquired solitary functioning kidney. This study aims to assess if there are any differences between these two types of solitary kidney patients.MethodsCurrent research is a retrospective study assessing the evolution of glomerular filtration rate, proteinuria, and blood pressure in clinical records of 55 children with a solitary functioning kidney (37 congenital and 18 acquired). We used the medical records of children who had been assisted, in our unit of pediatric nephrology, for a period of 14 years (168 months), from the time of diagnosis, between January/1997 and December/2015.ResultsDuring the study period, glomerular filtration rate (T0 128.89 ± 32.24 vs T14 118.51 ± 34.45 ml/min/1.73 m2, p NS) and proteinuria (T0 85.14 ± 83.13 vs T14 159.03 ± 234.66 mg/m2/die, p NS) demonstrated no significant change. However, after 14 years of follow-up 76.4% of patients had increased levels of arterial hypertension with values over the 90th percentile for gender, age, and height. Specifically, children with an acquired solitary functioning kidney mainly developed hypertension [T0 2/17 (12%) vs T14 9/17 (52.9%) p < 0.025], whereas children with a congenital solitary functioning kidney mainly developed pre-hypertension [T0 3/38 (7.9%) vs T14 17/38 (44.7%) p < 0.0005].ConclusionsThe renal function of children with solitary functioning kidneys remains stable during a follow-up of 14 years. However, these children should be carefully monitored for their tendency to develop arterial blood pressure greater than the 90th percentile for gender, age, and height.

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“…In children with a congenital single kidney, physical activity improved aerobic capacity and exercise tolerance without increasing the risks of cardiovascular accidents [64], however, in the patients contact sports might be discouraged due to the increased risk of sport-related injury.…”

Section: Cardiorespiratory Fitness In Children With Chronic Kidney Di...mentioning

confidence: 99%

The Role of Cardiorespiratory Fitness in Children with Cardiovascular Risk

Močnik¹,

Varda²

2023

Cardiorespiratory Fitness - New Topics

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Cardiorespiratory fitness is an outcome of physical activity, enabling the transport of oxygen from the atmosphere to the mitochondria to perform physical work and therefore reflects the overall capacity of the cardiovascular and respiratory systems to perform the prolonged exercise. In recent decades, it has declined in the paediatric population. Cardiovascular fitness measurement has yet to be standardised in children but is a powerful marker of health in youth and is strongly associated with inflammation and inversely associated with cardiovascular risk factors, especially obesity. Notably, youth with low cardiorespiratory fitness levels have a higher risk of developing cardiovascular diseases during adulthood. Lowered cardiorespiratory fitness has been demonstrated most often in children with obesity and associated cardiovascular comorbidities, however, these can be associated with cardiorespiratory fitness independently to body mass index. The benefits of physical activity on health have been well demonstrated during growth and it should be encouraged in children with cardiovascular risk to prevent further reduction of cardiorespiratory fitness and the development of other comorbidities. Along with appropriate physical exercise and diet in childhood, breastfeeding in the first year of life is recommended.

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Cardiorespiratory fitness and sports activities in children and adolescents with solitary functioning kidney

Cited by 8 publications

References 34 publications

Life with one kidney

Life with one kidney

Evolution of blood pressure in children with congenital and acquired solitary functioning kidney

The Role of Cardiorespiratory Fitness in Children with Cardiovascular Risk

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