Grinsell Matthew M, Showalter Sharon, Gordon Katherine A, Norwood Victoria F
Department of Pediatrics, Division of Nephrology, University of Virginia, 1224 Jefferson Park Ave, Suite 701, Charlottesville, Virginia 22903, USA.
Pediatrics. 2006 Sep;118(3):1019-27. doi: 10.1542/peds.2006-0663.
Physician opinions and practice patterns regarding the participation of children and adolescents with single, normal kidneys in contact/collision sports are widely varied. We hypothesize that limitation of participation from play based only on the presence of a single kidney is not supported by available data. We sought to determine recommendations of pediatric nephrologists regarding the participation of patients with single, normal kidneys in contact/collision sports and review the literature to determine the rate of sports-related kidney injury compared with other organs.
Members of the American Society of Pediatric Nephrology were surveyed regarding their recommendations for participation of patients with single, normal kidneys in contact/collision sports. Medical and sports literature databases were searched to determine sports-related kidney, brain, spinal cord, and cardiac injury rates and the sports associated with kidney injury.
Sixty-two percent of respondents would not allow contact/collision sports participation. Eighty-six percent of respondents barred participation in American football, whereas only 5% barred cycling. Most cited traumatic loss of function as the reason for discouraging participation. The literature search found an incidence of catastrophic sports-related kidney injury of 0.4 per 1 million children per year from all sports. Cycling was the most common cause of sports-related kidney injury causing > 3 times the kidney injuries as football. American football alone accounted for 0.9 to 5.3 fatal brain injuries and 4.9 to 7.3 irreversible spinal cord injuries per 1 million players per year. Commotio cordis causes 2.1 to 9.2 deaths per year.
Most pediatric nephrologists prohibit contact/collision sports participation by athletes with a single kidney, particularly football. The available evidence suggests that cycling is far more likely to cause kidney injury. In addition, kidney injury from sports is much less common than catastrophic brain, spinal cord, or cardiac injury. Restricting participation of patients with a single, normal kidney from contact/collision sports is unwarranted.
医生对于单肾正常的儿童和青少年参与接触性/碰撞性运动的观点和实践模式差异很大。我们假设，仅基于单肾的存在而限制其参与运动并没有现有数据的支持。我们试图确定儿科肾脏病专家对于单肾正常的患者参与接触性/碰撞性运动的建议，并回顾文献以确定与其他器官相比，运动相关肾损伤的发生率。
对美国儿科肾脏病学会的成员进行调查，询问他们对于单肾正常的患者参与接触性/碰撞性运动的建议。检索医学和体育文献数据库，以确定运动相关的肾、脑、脊髓和心脏损伤发生率以及与肾损伤相关的运动项目。
62%的受访者不允许参与接触性/碰撞性运动。86%的受访者禁止参与美式橄榄球运动，而只有5%的受访者禁止骑自行车。大多数人将功能的创伤性丧失作为不鼓励参与的原因。文献检索发现，所有运动项目中，每年每百万儿童发生灾难性运动相关肾损伤的发生率为0.4。骑自行车是运动相关肾损伤的最常见原因，导致的肾损伤是橄榄球运动的3倍多。仅美式橄榄球运动每年每百万运动员就有0.9至5.3例致命性脑损伤和4.9至7.3例不可逆脊髓损伤。心脏震荡每年导致2.1至9.2例死亡。
大多数儿科肾脏病专家禁止单肾运动员参与接触性/碰撞性运动，尤其是橄榄球运动。现有证据表明，骑自行车导致肾损伤的可能性要大得多。此外，运动导致的肾损伤比灾难性脑、脊髓或心脏损伤要少见得多。限制单肾正常的患者参与接触性/碰撞性运动是没有必要的。
