Recommending exercise and sports for children and adolescents with a solitary kidney after a renal tumor: A view on current evidence-based risks and decisions

Abstract

Whether or not children and adolescents with solitary kidney due to renal tumors can play the same sports as their peers has been a matter of extensive debate. This especially pertains sports bearing a potential risk of genitourinary injuries. Cancer patients are encouraged to live a normal life, yet children and adolescents with cancer have a reduced exercise tolerance matched with a lower energy expenditure compared to their peers. Engagement in sports could be a fundamental facilitator of living well also for individuals with one kidney or with a kidney disease. Exercising is important to counteract the impaired anabolic and activated catabolic pathways, chronic inflammation and oxidative stress resulting from chronic kidney disease.Guidelines, where available, addressing the safe participation of children and adolescents with a solitary kidney in middle or high-impact sports do not share a common vision worldwide. Our own experience and the literature suggest that some doctors feel that a renal cancer diagnosis leading to solitary kidney condition makes it unsafe to practice some team sports. In order to instigate action at a variety of levels, high-quality evidence on incidence of renal trauma in sports is required to achieve positive change at individual and systems levels. Oncology providers may contribute in informed counselling patients and their families on which sport is safe, in order to promote an active lifestyle.This paper reconsiders epidemiology on pediatric sport-related renal injuries and provides considerations for more evidence-based decisions, and proposes a renewed classification of sports at risk.

Keywords

• Wilms tumor
• Childhood cancer
• Solitary kidney
• Chronic kidney disease
• Exercise
• Sports