Sports participation and the solitary kidney, with particular reference to the child athlete
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The aims of this systematic review were to analyze the risks of renal injury during various sports and to recommend appropriate management with particular reference to individuals with a solitary kidney. The Ovid/Medline data-base was searched from 1996 to August 2015. The terms sports/sports medicine, athletes or physical activity were combined with the terms wounds and injuries/kidneys to yield 27 citations relevant to the review. This data base was supplemented extensively from journal reference lists and the author's personal files to provide a total of 56 citations. Review articles suggest that many physicians are still very cautious in recommending some forms of sport to children with single kidneys, while permitting other more dangerous activities. The absolute risks of renal injury are very low but not non-existent for most sports; for instance, there are 2.6 incidents per million exposures in male soccer players. Many renal injuries are minor, and only a small minority require nephrectomy. Contact sports account for perhaps a fifth of physical activity-related renal trauma, but the operation of all-terrain vehicles, cycling, Alpine sports and horse-back riding are all more common sources of injury. Possible factors modifying inherent risks include parental supervision, the wearing of protective equipment, initial renal health, and the individual's age (children being more vulnerable than adults). Minor renal injuries may require only 2-6 weeks of restricted activity; often, there are no long-term consequences, but subcapsular haematomas can cause a pressure necrosis of renal tissue, with later risks of hypertension, proteinuria and renal insufficiency. Sports physicians must communicate the objective level of risk to the parents of children with a single kidney, emphasizing that sport carries greater dangers for the head than the kidneys, and that serious renal injury is more likely from motor traffic than from sport participation. Moreover, they must underline the importance of continued regular physical activity to the overall health and development of the child. Nevertheless, they should also underline the need to take all reasonable precautions to reduce risk, including the avoidance of activities likely to involve collisions and blunt trauma.
Abstract
The aims of this systematic review were to analyze the risks of renal injury during various sports and to recommend appropriate management with particular reference to individuals with a solitary kidney. The Ovid/Medline data-base was searched from 1996 to August 2015. The terms sports/sports medicine, athletes or physical activity were combined with the terms wounds and injuries/kidneys to yield 27 citations relevant to the review. This data base was supplemented extensively from journal reference lists and the author's personal files to provide a total of 56 citations. Review articles suggest that many physicians are still very cautious in recommending some forms of sport to children with single kidneys, while permitting other more dangerous activities. The absolute risks of renal injury are very low but not non-existent for most sports; for instance, there are 2.6 incidents per million exposures in male soccer players. Many renal injuries are minor, and only a small minority require nephrectomy. Contact sports account for perhaps a fifth of physical activity-related renal trauma, but the operation of all-terrain vehicles, cycling, Alpine sports and horse-back riding are all more common sources of injury. Possible factors modifying inherent risks include parental supervision, the wearing of protective equipment, initial renal health, and the individual's age (children being more vulnerable than adults). Minor renal injuries may require only 2-6 weeks of restricted activity; often, there are no long-term consequences, but subcapsular haematomas can cause a pressure necrosis of renal tissue, with later risks of hypertension, proteinuria and renal insufficiency. Sports physicians must communicate the objective level of risk to the parents of children with a single kidney, emphasizing that sport carries greater dangers for the head than the kidneys, and that serious renal injury is more likely from motor traffic than from sport participation. Moreover, they must underline the importance of continued regular physical activity to the overall health and development of the child. Nevertheless, they should also underline the need to take all reasonable precautions to reduce risk, including the avoidance of activities likely to involve collisions and blunt trauma.
참고문헌 (56)
- Acton, C. H., "Bicycle incidents in children-abdominal gtrauma and handlebars", Medical Journal of Australia, 160(6), pp.344~346 (1994)
- Anderson, C. R., "Solitary kidney and sports participation", Archives of Family Medicine, 4(10), pp.885~888 (1995)
- Arguieso, L. R., "Prognosis of patients with unilateral renal agenesis", Pediatric Nephrology, 6(5), pp.412~416 (1992)
- Bagga, H. S., "Sports-related genitourinary injuries presenting to United States emergency departments", Urology, 85(1), pp.239~245 (2015)
- Banowsky, L. H., "Considersations in diagnosis and management of renal trauma", Journal of Trauma, 10(7), pp.587~597 (1970)
- Bergqvist, D., "Abdominal injury from sporting activities", British Journal of Sports Medicine, 16(2), pp.76~79 (1982)
- Bernard, J. J., "Renal trauma : Evaluation, management and return to play", Current Sports Medicine Reports, 8(2), pp.98~103 (2009)
- Birrer, R. B., "Trauma epidemiology in the martial arts: The results of an eighteen year international survey", American Journal of Sports Medicine, 24(6Suppl), pp.S72~S79 (1996)
- Brophy, R. H., "Kidney injuries in professional American football. Implications for management of an athlete with 1 functioning kidney", American Journal of Sports Medicine, 36(1), pp.85~90 (2008)
- Buckley, J. C., "Revision of current American Association for the Surgery of Trauma Renal Injury grading system", Journal of Trauma, 70(1), pp.35~37 (2011)
- Burd, R., "American Pediatric Surgical Association Trauma Committee position statement on the use of all-terrain vehicles by children and youth", Journal of Pediatric Surgery, 44(8), pp.1638~1639 (2009)
- Clarnette, T. D., "Handlebar injuries in children : patterns and prevention", Australia & New Zealand Journal of Surgery, 67(6), pp.338~339 (1997)
- De Meersman, R. B., "Judo nephropathy : trauma versus non-trauma", Journal of Trauma, 22(2), pp.150~152 (1982)
- Dyment, P.G., "Recommendations for participation in competitive sport", Pediatrics, 81(5), pp.737~739 (1988)
- Eckert, V., "Equestrian injuries caused by horse kicks : First results of a prospective multicenter study", Clinical Journal of Sports Medicine, 21(4), pp.353~355 (2011)
- El-Shirbiny, M. T., "Late renal functional and morphological evaluation after non-operative treatment of high-grade renal injuries in children", BJU International, 93(7), pp.1053~1056 (2004)
- Gerstenbluth, R. E., "Sports participation and high grade renal injuries in children", Journal of Urology, 168(6), pp.2575~2578 (2002)
- Ghosh, A., "Horse-related injuries in pediatric patients", Journal of Pediatric Surgery, 35(12), pp.1766~1770 (2000)
- Goulet, C., "Risk factors associated with alpine skiing injuries in children. A case-control study", American Journal of Sports Medicine, 27(5), pp.644~650 (1999)
- Grinsell, M. M., "Sport related kidney injury among high school athletes", Pediatrics, 130, pp.e40~e55 (2012)
- Grinsell, M. M., "Single kidney and sports participation : perception versus reality", Pediatrics, 118(3), pp.1019~1027 (2006)
- Guerrero, M. A., "Subcapsular hematoma of the kidney secondary to paintball pellet injuries", Journal of Emergency Medicine, 36(3), pp.300~301 (2009)
- Holmes, F. C., "Renal injury in sport", Current Sports Medicine Reports, 2, pp.103~109 (2003)
- Itagaki, M. W., "Kidney trauma in martial arts. A case report of kidney contusion in jujitsu", American Journal of Sports Medicine, 32(2), pp.522~524 (2004)
- Jagodzinski, T., "Horse-related injuries in children : a review", Wisconsin Medical Journal, 104(2), pp.50~54 (2005)
- Johnson, B., "A need for reevaluation of sports participation recommendations for children with a solitary kidney", Journal of Urology, 174(2), pp.686~689 (2005)
- Keller, M. S., "Functional outcomes of nonoperatively managed renal injuries in children. Journal of Trauma, Injury", Infection &Critical Care, 57(1), pp.108~110 (2004)
- Klimek, P. M., "Handlebar injuries in children", Pediatric Surgery International, 29(3), pp.269~273 (2013)
- Kubiak, R., "Unpowered scooter injuries in children", Acta Paediatrica, 92(1), pp.50~54 (2003)
- Lee, S., "Renal trauma in Australian Rules football : an institutional experience", Australian & New Zealand Journal of Surgery, 74(9), pp.766~768 (2004)
- MacAuley, D., "Evidence-based sports medicine" (2008), John Wiley
- Machida, T., "Snowboarding injuries of the abdomen: comparison with skiing injuries", Injury, 30(1), pp.47~49 (1999)
- Mandell, J., "Sports-related genitourinary injuries in children", Clinics in Sports Medicine, 1, pp.483~493 (1982)
- McAleer, I. M., "Renal and testis injuries in team sports", Journal of Urology, 168(4 Part 2), pp.1805~1807 (2002)
- Nataraja, R. M., "The full spectrum of handlebar injuries in children : A decade ofexperience", Injury, 45(4), pp.684~689 (2014)
- Patel, D. R., "Kidney and sports", Adolescent Medicine Clinics, 16, pp.111~119 (2005)
- Psooy, K., "Sports and the solitary kidney : How to counsel parents", Canadian Journal of Urology, 13(3), pp.3120~3126 (2006)
- Psooy, K., "Sports and the solitary kidney : what parents of a young child with a solitary kidney should know", Canadian Urological Association Journal, 3(1), pp.67~68 (2009)
- Psooy, K., "Sports and the solitary kidney: What parents of a young child with a solitary kidney should know", Canadian Urological Association Journal, 8(7-8), pp.233~235 (2014)
- Radmayr, C., "Blunt renal trauma in children : 26 years clinical experience", European Urology, 42(3), pp.297~300 (2002)
- Rice, S.G., "Medical conditions affecting sports participation", Pediatrics, 121, pp.841~848 (2008)
- Risser, W.L, "Medical conditions affecting sport paticipation", Pediatrics, 94(5), pp.757~760 (1994)
- Sacco, E., "Sports and genitourinary traumas", Urologia, 77(2), pp.112~115 (2010)
- Santucci, R., "Diagnosis and management of renal trauma : past, present, and future", Journal of the American College of Surgeons, 191, pp.433~451 (2000)
- Sharp, D. S., "Attitudes of pediatric urologists regarding sports participation by children with a solitary kidney", Journal of Urology, 168(4 Pt 2), pp.1811~1814 (2002)
- Shorter, N. A., "Childhood sledding injuries", American Journal of Emergency Medicine, 17(1), pp.32~34 (1999)
- Sparnon, A. L., "Bicycle handlebar injuries in children", Journal of Pediatric Surgery, 21(2), pp.118~119 (1986)
- Spreafico, F., "Why should survivors of childhood renal tumor and others with only one kidney be denied the chance to play contact sports?", Expert Reviews in Anticancer Therapy, 14(4), pp.363~366 (2014)
- Styn, N. R., "Urological sports injuries in children", Current Urological Reports, 11(2), pp.114~121 (2010)
- Sulheim, S., "Risk factors for injuries in alpine skiing, telemark skiing and snowboarding –case-control study", British Journal of Sports Medicine, 45(16), pp.1303~1309 (2011)
- Wan, J., "The incidence of recreational genitourinary and abdominal injuries in the western New York pediatric population", Journal of Urology, 170(4 part 2), pp.1526~1127 (2003)
- Wan, J., "Kidney and testicle injuuries in team and individual sports: Data from the national pediatric trauma registry", Journal of Urology, 170(4 Part2), pp.1528~1532 (2003)
- Washington, R. L., "Medical conditions affecting sports participation", Pediatrics, 107(5), pp.1205~1209 (2001)
- Winston, F. K., "Hidden spears : Handlebars as injury hazards to children", Pediatrics, 102(3), pp.596~601 (1998)
- Wu, H-Y., "Dirt bikes and all-terrain vehicles: The real threat to pediatric kidneys", Journal of Urology, 178(4 Part 2), pp.1672~1674 (2007)
- Yanchar, T., "Canadian Association of Pediatric Surgeons' position statement on the use of all-terrain vehicles by children and youth", Journal of Pediatric Surgery, 43(5), pp.938~939 (2008)