Sports participation and the risk of high-grade kidney injuries in children with a solitary kidney. Systematic Review Dataset.

Recommendations for excluding children with a solitary kidney from recreational activities are variable. To better inform the true incidence of functional or physical kidney loss, we conducted a systematic review to assess the risk of grade IV and V kidney injury due to common children's sports. Data was obtained from MEDLINE, PubMed, CINAHL, EMBASE, and CENTRAL, considering all study types that reported injuries due to basketball, cycling, equestrian, motorsports, netball, rugby, football or soccer. Studies were excluded if patients were: exclusively aged 18 years or older, suffered non-traumatic kidney injuries, or injured by mechanisms not relating to recreational activities/sport.<br>Twenty-five studies with a total of 24,424 patients were included. The estimated chance of losing a kidney due to sports injuries is 0.37 per million children-years. However, the incidence of grade IV and V injuries could not be calculated in at-risk populations due to a lack of prospective data. The prevalence of traumatic kidney injuries from sport-specific trauma was low, ranging from 0.6-2.2%. Grade IV and V injuries were observed in 33% of soccer, 26% of bicycling injuries, 23% of Australian football, 20% of basketball, and 17% of equestrian. However, the high number of ungraded kidney injuries (5,514/5,607) impacts the reliability of these findings. Recommendations to exclude children with congenital single kidneys from specific sports lack a firm evidence base. Given the bio-psycho-social consequences, such recommendations must be carefully considered. Particularly for equestrian activities and motorized vehicles, which carry a higher risk of trauma but offer primarily psychosocial benefits.