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Published online in the journal Pediatrics, the study sheds light on the frequency and severity of kidney injuries among young athletes. Doctors often recommend that youth with only one kidney not be allowed to participate in contact sports because of a lack of hard data.

“Many people have restricted that activity in the past because of concern about the loss of the kidney, but we’ve been able to show that the risk is really extraordinarily small,” says Victoria Norwood, professor of pediatrics and chief of pediatric nephrology at the University of Virginia.

“Children with single kidneys—and it’s important to note normal single kidneys—are really at exceedingly minimal risk from routine contact sports and therefore should be allowed to participate as they and their families desire.”

A review of more than 23,600 injuries among varsity athletes reported between 1995 and 1997, showed there were only 18 kidney injuries—and none were catastrophic or required surgery. In comparison, there were 3,450 knee injuries and 2,069 head/neck/spine injuries, and 1,219 cases of mild traumatic brain injury.

Children and teens with only one kidney are often kept off the football field in particular even when they are allowed to engage in other activities that may actually pose much greater kidney risk, Norwood says.

“Football seems to cause the most concern for physicians, not realizing that they were not restricting downhill skiing, horseback riding, or bicycling. Those are activities that are not intended as contact sports, but the truth of the matter is you do hit things in those activities, and when you do, the outcome can be quite catastrophic.”

Birth defects are the most common reason children have only one kidney. Norwood says there is little chance that contact in youth sports could generate the force necessary to do severe kidney damage.

Researchers hope the study results will allow the American Academy of Pediatrics to offer more specific recommendations and allow high school athletes with to participate. The academy’s current stance is a “qualified yes” on whether athletes with one kidney should be allowed to play, but that position leaves physicians with little specific guidance, so most just say no.

The new data should let doctors feel more comfortable allowing young athletes to take the field, Norwood says.

“In today’s world, where kids get too little exercise anyway, we have an obesity epidemic,” she says. “The last thing we need to do is discourage exercise of any type, unless there is real evidence behind that restriction.”

More news from the University of Virginia: www.virginia.edu/uvatoday