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Minerva Pediatrica 2015 February;67(1):99-104


language: Italian

Differences in sports participation for children and adolescents with solitary kidney due to renal tumors across Europe. Time for harmonization

Spreafico F. 1, Terenziani M. 1, Ardissino G. 2, Calegari M. 3, Catania S. 1, Massimino M. 1

1 Struttura Complessa di Pediatria Oncologica, Dipartimento di Ematologia e Oncoematologia Pediatrica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italia; 2 Unità Operativa Complessa di Nefrologia e Dialisi Pediatrica, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italia; 3 Studio Professionale di Medicina Sportiva, Lecco, Italia


As a result of advances in treatment, almost 90% of children diagnosed with Wilms tumor became long-term survivors, and have a sustainable quality of life. These patients’ involvement in sports during their childhood is hopefully increasing too. The cornerstone of renal tumor cure remains radical nephrectomy, however, so survivors live with a solitary kidney. In most European countries and the USA, the involvement in sports of children with a solitary kidney depends on a responsible physician saying a “qualified yes”, pending individual assessment. Unlike the case in the rest of Europe, in Italy having only one kidney automatically disqualifies an individual wishing to participate in any organized “competitive” sports carrying some risk of renal trauma, including basketball, soccer and sometime volleyball. This absolute restriction is based on ad hoc Ministerial rulings concerning “Health protection in sport activities”. But available data do not seem to support such an absolute limitation on participation in sports based exclusively on the fact of having a single kidney. The sport-specific incidence of kidney injuries has been estimated at 2.3 injuries per million male athlete/exposures for basketball (2.5 for females), and 2.6 for soccer (6.0 for girls). Kidney injuries are significantly more rare than head or spine injuries. This article aims to provide Italian sport medicine specialists and policy-makers with the necessary background so that the current, over-protective “unquestionably no” response can be reconsidered, and converted into a still well-founded, more permissive attitude to the sports activities suitable for any children with a solitary normal kidney.

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