Sport-Related Kidney Injury Among High School Athletes

Abstract

WHAT'S KNOWN ON THIS SUBJECT:Children with a single kidney are often counseled to avoid contact/collision sports based on the concern of injury to the kidney; however, the incidence of kidney injury during sport is not well understood.WHAT THIS STUDY ADDS: Based on this multiyear, prospective injury surveillance system of varsity-level high school athletes, sport-related kidney injury is rare. Reevaluation of American Academy of Pediatrics recommendations regarding sport participation by children with a single kidney is indicated. abstract BACKGROUND AND OBJECTIVE: The American Academy of Pediatrics recommends a "qualified yes" for participation by athletes with single kidneys in contact/collision sports. Despite this recommendation, most physicians continue to discourage participation in contact/collision sports for patients with single kidneys. A major concern is the lack of prospective data quantifying the incidence of sport-related kidney injury. The objective was to quantify the incidence of sport-related kidney injury among high school varsity athletes and compare it with sport-related injuries of other organ systems. METHODS:Data from the National Athletic Trainers' Association High School Injury Surveillance Study, an observational cohort study collected during the 1995-1997 academic years, were used. Incidence rates for sport-specific injuries to select organs were computed and compared.RESULTS: Over 4.4 million athlete-exposures, defined as 1 athlete participating in 1 game or practice, and 23 666 injuries were reported. Eighteen kidney injuries, none of which were catastrophic or required surgery, were reported compared with 3450 knee, 2069 head/neck/spine, 1219 mild traumatic brain, 148 eye, and 17 testicle injuries. Student athletes incurring kidney injuries were most often playing football (12 injuries) or girls' soccer (2 injuries). Sport-specific rates of kidney injury were significantly lower than sport-specific rates of mild traumatic brain, head/neck/spine, and knee injuries for all sports as well as rates of baseball-and basketball-specific eye injuries (P , .01).

Current Epidemiology of Genitourinary Trauma

“…None of these injuries required surgical management or resulted in known loss of renal function. [33] For boys, football had the highest rate of renal injury (rate 9.2 injuries/million athlete-exposures). Girls had the highest risk of sustaining a renal injury while playing soccer (5.9 injuries/million athlete-exposures).…”

“…Overall, the risk of renal injury was significantly less than rates of traumatic brain/head/neck/spine injuries and it was concluded that patients with solitary kidneys should be allowed to participate in contact sports. [33]…”

Reconsidering Physical Activity Restrictions for Mononephric Survivors of Childhood Cancer

“…The risk of sports-related renal loss should be presented in context—renal loss from sports participation is rare and results more often from motor vehicle accidents and falls than sports. Patient and family education should reinforce that physical activity poses little risk to the kidney and is strongly encouraged, since sports participation by children and adolescents has positive benefits in physical health, mental health, academic performance, self-esteem, and self-concept (Biddle & Asare, 2011; Dobbins, Husson, DeCorby, & LaRocca, 2013; Grinsell et al, 2012; Strong et al, 2005). Although this recommendation has significant implications for those who have required nephrectomies for management of their pediatric cancer and other populations with a single or partial kidney, it is important to respect that there are some individuals who will elect to continue avoiding certain activities after a thorough discussion of the risks and benefits of previously restricted activities.…”

Chronic kidney disease and sports participation by children and adolescents

“…Though there has been a lot of debate and concerns over the participation in contact sports by children and adolescents with a solitary kidney, the current recommendations favor allowing participation after a thorough patient and family education about potential risks to the solitary kidney (57)(58)(59)(60). This recommendation also extends for those with CKD, and those receiving dialysis therapy (60). In case of a transplanted kidney, the kidney is placed in the extra peritoneal space in the abdomen and thereby is at a relatively higher risk for injury when compared to native solitary kidney.…”