|
PRACTICAL
SIGNIFICANCE
The
purpose
of this
study is
to
review
the
National
Athletic
Trainer’s
Association
(NATA)
injury
surveillance
program
database
for
information
regarding
kidney
injury
during
high
school
varsity
sports
participation.
This
information
will be
published
to
assist
physicians,
families
and
athletes
in
making
evidence-based
decisions
regarding
the
participation
of
children
and
adolescents
with
single,
normal
kidneys
in
contact/collision
sports.
STUDY
BACKGROUND
The
American
Academy
of
Pediatrics
recommends
a
“qualified
yes”
favoring
participation
of
athletes
with
single
kidneys
in
contact/collision
sports.
Despite
this
recommendation
and
minimal
published
data,
most
physicians
continue
to
discourage
participation
in
contact/collision
sports
for such
patients.
OBJECTIVE
The
primary
objectives
of this
study
were to:
1.
Evaluate
the NATA
High
School
Injury
Surveillance
database
to
identify
any
occurrences
of
sports
related
kidney
injury;
2.
Determine
which
contact/collision
sports,
if any,
are
associated
with an
increased
risk of
catastrophic
kidney
injury;
3.
Compare
the
incidence
of
catastrophic
kidney
injury
to
serious
reportable
injuries
of other
organ
systems
such as
brain,
spine,
eye and
knee and
4. Use
the NATA
High
School
Injury
Surveillance
database
to
increase
the
available
evidence
to
assist
physicians
in
making
recommendations
for
athletes
with
single,
normal
kidneys.
DESIGN
AND
SETTING
The
NATA
High
School
Injury
Surveillance
database
is a
three-year
observational
cohort
study.
Injury
and
participation
information
for
varsity
athletes
was
collected
during
all
practice
and game
sessions.
SUBJECTS
During
the
1995-1997
academic
years,
246
certified
athletic
trainers
(ATCs)
representing
235 US
high
schools
monitored
varsity
boy’s
football,
baseball,
and
wrestling,
girl’s
volleyball,
softball,
and
field
hockey
and
boy’s
and
girl’s
basketball
and
soccer.
23,666
total
injuries
were
recorded
from
74,298
team
seasons
and over
4.4
million
injury
exposures.
MEASUREMENTS
The ATCs
present
at each
game and
practice
session
reported
injuries
and
participation
data via
a
standardized
surveillance
protocol.
Injury
case
rates
(injuries/thousand
exposures)
for
kidney,
head/neck/spine,
mild
traumatic
brain
injury (MTBI),
knee,
eye and
testicle
were
calculated.
Differences
in
injury
rates
between
organs
and
sports
were
calculated
using an
incidence
density
ratio (IDR).
Statistical
analysis
was
performed
using
the
SigmaStat
software.
RESULTS
This
study
investigated
6,921 of
the
23,666
total
injuries
in the
NATA
High
School
Injury
Surveillance
database
including
18
kidney
injuries,
2,069
head/neck/spine,
1,219
MTBI,
3,450
knee,
148 eye,
and 17
testicle.
None of
the
kidney
injuries
were to
a single
kidney
or lead
to loss
of
function.
Kidney
injuries
were
reported
for
football
(12),
girl’s
soccer
(2), and
boy’s/girl’s
basketball,
boy’s
soccer
and
baseball
(1
each).
Softball,
field
hockey,
girl’s
volleyball,
and
wrestling
had no
reported
kidney
injuries.
For all
sports,
the
injury
case
rates
for
kidney
(0.002 -
0.009)
were
significantly
less
than
head/neck/
spine
(0.05 -
1.08),
MTBI
(0.02-0.59),
and knee
(0.2-1.22)
(P<0.01).
Kidney
injury
case
rate was
less
than eye
(0.047-0.056)
for
baseball
and
boys’
and
girls’
basketball
(P<0.01).
Compared
to
kidney
injury,
IDR’s
among
all
sports
for
head/neck/spine
(16-117),
MTBI
(15-69),
and knee
(90-274)were
significantly
higher
than
kidney
among
all
sports (P<0.01).
In
baseball
and
boy’s/girl’s
basketball,
IDR’s
for eye
injury
(16-23)
were
significantly
higher
than
kidney (P<0.01).
CONCLUSIONS
Sports-related
kidney
injuries
are
exceedingly
rare and
occur
significantly
less
often
than
MTBI,
knee and
head/neck/
spine
injuries
among
common
high
school
sports.
Limitation
of
athletic
participation
based
solely
on the
presence
of a
single
kidney
is
unwarranted.
|
Publication
and
Presentation
List:
-
Grinsell
MM,
Graslie
KA,
Powell
JW,
Gurka
MJ,
Gurka
KK,
Norwood
VF.
Sports
Related
Kidney
Injury:
A
Prospective
Assessment
of
Relative
Risk.
American
Society
of
Nephrology
General
Meeting,
San
Diego,
CA
2006.
|
|
Matthew M. Grinsell, MD, PhD
Principal Investigator |
|
Matthew M. Grinsell received his M.D. degree from the University of Nevada School of Medicine, and Ph.D. degree in Cell and Molecular Biology for the University of Nevada, Reno. Currently, Dr. Grinsell is completing his Fellowship in the Division of Nephrology within the Department of Pediatrics at the University of Virginia. |
| |
Matthew M. Grinsell, MD, PhD
Fellow Physician
Pediatric Nephrology
PO Box 800136
University of Virginia
Charlottesville, VA 22908-0136
434-924-0000
mmg4x@Virginia.EDU |
|
|
This
Grant
Information
Summary
may be
downloaded
in a
2-page
pdf file
from
http://www.natafoundation.org/pdfs/07Grinsell.pdf. |
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