Pediatric cancers, yes to sport for children who only have one kidney

To illustrate an all-Italian research paper published in the authoritative scientific journal Nature Reviews Urology

Bologna, March 24, 2022 – In pediatric patients who find themselves with only one kidney, either from birth (1 in 1500) or due to a tumor – with ongoing treatments or recovery, like most of those who have defeated Wilms cancer – exercise has undeniable benefits It can be proven.

This was confirmed by Dr. Filippo Spreafico – Medical Director at IRCCS National Cancer Institute of Milan and Coordinator of the AIEOP (Italian Association of Pediatric Hematology and Oncology) Working Group on Kidney Tumors – in a recent analysis published in the February issue of the authoritative scientific journal Nature Reviews Urology.

The article, titled “Recommend exercise for children with one kidney,” not only removes any doubts about the actual benefits of physical exercise for children and adolescents who have only one kidney, but attempts to clarify once and for all the potential risks of physical exercise. Especially from the practice of the so-called “contact sports”, with the order of conflicting opinions expressed over the years on this subject by the global scientific community.

In many European countries and in the United States, there is a significant trend in favor of team sports – including football – with restrictions relating exclusively to competitive sports with “strong” physical contact, of which cancer patients with only one kidney. Excluded. However, this should not be the case with volleyball or basketball, where the risks of a strong physical collision such as severe kidney trauma are estimated to be very low.

“It is a topic of debate – says Dr. Spreafico – whether or not it is safe for people with one kidney to participate in high-impact team sports such as football and rugby, but current evidence suggests that the potential for kidney injury during these sports is low, and less than developing such as head injuries.In the pediatric category, the reported rate of kidney injuries attributed to American football is 0.1-0.7% of all sports injuries and 0.07-0.5% of all sports injuries overall.Moreover, these are often Traumas are minor and do not require any surgery or cause permanent dislocations.”

The current uncertainty about the indications to give children with only one kidney in relation to the most common team sports practice arises from the fact that the classification of sports based on the strength of contacts is equivocal. Based on our data on the incidence of trauma, the sports activities associated with increased rates of kidney damage include cycling, downhill skiing, downhill skiing, snowboarding, horseback riding, and the use of off-road vehicles or bicycles.

However, cycling, skiing, skateboarding, horseback riding, and snowboarding are classified as “limited contact” sports by the American Academy of Pediatrics (and, therefore, not subject to significant restrictions), while basketball and football are classified as “limited contact” sports. contact or collision.

“Based on the available data, we believe – adds Spreafico – that the benefits derived from participating in physical exercise and sports, including competitive and team sports, for children recovering from Wilms’ tumor could well exceed the minimal risks associated with succumbing to residual kidney damage. Among motor vehicles is the highest risk of childhood kidney injury, yet no one has suggested excluding young adults who have Wilms cancer and have only one kidney from obtaining a driver’s license.

So engaging in physical exercise can be essential to improving the quality of life for people with kidney or kidney disease, who tend to be very inactive. In particular, it has been shown that for patients with chronic kidney disease, the importance of avoiding a sedentary lifestyle is key (in a study of more than 400,000 participants, how exercise can affect the risk of some cancers was analyzed based on the intensity and consistency with which it is exercised).

However, most pediatric patients are not active enough to enjoy these benefits: Children and adolescents show a significant reduction in exercise and sports when they are diagnosed with cancer, and their activity levels often do not fully recover even after treatment.

This is why pediatric oncologists, urologists and nephrologists often recommend sports to cancer patients: albeit with some caution, especially with regard to sports with a real risk of kidney trauma, each patient can be guided in the choice of sports Most pleases him, even as a team.

“Unfortunately – Spreafico concludes – there are no tested and approved lumbar protection systems that help prevent trauma completely, but as pediatric oncologists, we are working with experts to investigate this aspect as well.”