Grinsell MM et al. (2006) Single kidney and sports participation: perception versus reality. Pediatrics 118: 1019–1027

Consensus is lacking among medical professionals as to whether children and adolescents with a single, normal kidney should participate in contact/collision sports; faced with confusing guidance, many advise against participation. Contrary to this opinion, Grinsell and colleagues at the University of Virginia declare that precluding these patients from such activities is unwarranted.

The investigators analyzed data from a survey of members of the American Society of Pediatric Nephrology, and information retrieved from searches of literature databases on sports-related kidney, brain, spinal cord and cardiac injury. In total, 62% of respondents barred participation in contact/collision sports, the majority citing risk of renal injury and consequences of subsequent loss of function as primary reasons. According to the medical and sports data, cycling and skiing were the most dangerous sports in terms of damage to the kidney; American football, regarded as the most dangerous sport by 86% of the survey respondents who banned sports participation, caused only about a third the number of injuries. Many more catastrophic injuries of the spinal cord, brain, and heart were recorded than of the kidney. For all sports, the incidence of catastrophic sports-related kidney injury was only 0.4 per million children per year.

Grinsell et al. believe that the benefits to be gained from sports participation outweigh the small risk of renal injury, and recommend that current practices and guidelines are reviewed and clarified.