Children who have only one functional kidney - such as kids born with just one organ, and those whose lives have been saved by kidney transplant - are routinely discouraged by their physicians from playing contact sports, even though the American Academy of Pediatrics says contact-sport participation is generally OK for them. Doctors' cautious attitudes have stemmed in part from the fact that no one has been sure how common sports-related kidney injuries are.
Now, a newly published Pediatrics paper from University of Utah researchers clears up the confusion. The paper evaluated the frequency of different kinds of injuries among high-school athletes playing varsity-level contact sports such as football and soccer, and it found that kidney injuries are rare. During 4.4 million "athlete exposures" (one child participating in one game or practice), a total of 23,666 injuries were reported. These included just 18 kidney injuries, none of which were catastrophic or needed surgery. Mild traumatic brain injuries, knee injuries, and injuries to the head, neck and spine were far more common than kidney injuries.
Children with a single kidney should still receive information from their physicians about the possible consequences of a severe kidney injury before participating in sports, the researchers say, but the information should be put in the appropriate context:
The documented reasons for restricting athletic activities in children with a single kidney usually focus on sequelae of catastrophic loss of the kidney and the risk of comorbidities and death associated with [end-stage renal disease]. It is therefore necessary to have a frank discussion with each family and athlete regarding the potential consequences of a serious renal injury that could occur during sports or other activities. Indeed, the risks of renal injury from nonathletic pursuits are far more common than those from sport participation. Motor vehicle crashes alone account for 2 to 10 times more renal injury than sport.
Our data show that the rate of significant injury to or loss of a kidney during participation in a number of high school varsity sports is low and appears to be lower than the rate of injury to other organs such as the brain and spinal cord in the same sports. These data do not support limiting sport participation by athletes with single kidneys. Reevaluation of the current guidelines and clarification of AAP recommendations is warranted to more accurately guide physicians, children, and families toward the healthiest and safest possible lives.
Previously: Study shows concussion recovery may take longer for female, younger athletes; Report finds brain injuries rising among high school football players and New guidelines for kids' participation in organized sports