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Having only one functioning kidney does not necessarily mean giving up sports. Whether a person is born with one kidney, donates one, or loses kidney function because of illness, physical activity can still be part of a healthy lifestyle. However, athletes with a solitary kidney may need to take a more individualised approach, particularly when participating in high-impact or contact sports. Dr Urmila Anandh, HOD, Nephrology, Amrita Hospital, Faridabad, says the question should not simply be whether someone with one kidney can play sports, but rather how they can participate safely. "Giving up competitive sports is not always necessary if you are born with one kidney, donate one, or lose one due to illness. It is more scientifically appropriate to ask, 'How can I play safely?' rather than, 'Can I play?' for many people who only have one functioning kidney," she says.
Is It Dangerous To Play Sports With One Kidney?
The biggest concern is the possibility of an injury to the remaining kidney. Unlike someone with two functioning kidneys, a person with a solitary kidney has less reserve if that kidney is seriously damaged. However, experts point out that severe kidney injuries related to sports are relatively uncommon. A study published in Pediatrics that examined more than 4.4 million athlete exposures among high school athletes recorded just 18 kidney injuries. Importantly, none of these injuries were life-threatening or required surgery. Kidney injuries were also much less common than injuries involving areas such as the knee, head, neck or spine. Another analysis estimated that catastrophic sports-related kidney injuries occur at a rate of approximately 0.4 cases per million children per year. These findings suggest that having one kidney does not automatically make sports participation unsafe.
Which Sports Need More Caution?
The level of risk depends heavily on the type of sport. Activities involving direct blows to the abdomen or flank may carry a greater theoretical risk of kidney trauma. These can include contact and collision sports, although the risk varies considerably between individual activities. Sports and activities that may require a more detailed risk assessment include:
- Football and other collision sports
- Martial arts and combat sports
- Hockey
- Cycling
- Skiing
- Motorised sports
- Horse riding and equestrian activities
- Other high-impact activities
Interestingly, kidney injuries are not limited to traditional contact sports. Cycling has also been associated with sports-related kidney injuries. This does not mean people with one kidney must automatically avoid these activities. Instead, the decision should consider the person's overall health, kidney function, the cause of having one kidney and the specific risks associated with the sport.
Why The Reason For Having One Kidney Matters
Not everyone with a solitary kidney has the same level of risk. Some people are born with one kidney, while others may have undergone kidney donation or lost a kidney because of disease or surgery. Doctors may therefore consider factors such as the health and function of the remaining kidney, blood pressure, urine protein levels and any underlying kidney condition before clearing someone for competitive sports. An athlete who has a completely healthy solitary kidney may have a different risk profile from someone whose remaining kidney already has reduced function.
What Tests Should Athletes Have?
Before participating in competitive or high-impact sports, people with one kidney should discuss their plans with a healthcare professional. Doctors may recommend checking:
- Blood pressure: High blood pressure can affect kidney health over time and may be particularly important to monitor in someone with a solitary kidney.
- Kidney function: Blood tests can help assess how effectively the remaining kidney is working.
- Urine protein: Protein in the urine can sometimes indicate kidney damage and may require further evaluation.
The athlete's medical history and the reason for having one kidney should also be considered.
Can Protective Equipment Prevent Kidney Injury?
Some athletes may consider protective equipment designed to shield the abdomen or flank. However, Dr Anandh points out that there is currently insufficient evidence to say that flank guards can reliably prevent severe kidney injuries during sports. Therefore, protective equipment should not create a false sense of security or replace proper risk assessment.
Should You Avoid Contact Sports Completely?
Historically, some guidelines and recommendations took a more restrictive approach toward sports participation among children and adults with a solitary kidney. However, more recent evidence has questioned whether blanket restrictions are appropriate. The risk of catastrophic kidney injury during sports appears to be very low, and decisions can increasingly be made on an individual basis. That means athletes should discuss their specific sport with their doctor rather than assuming that having one kidney automatically rules them out of competitive activity.
Why Staying Active Still Matters
Avoiding all physical activity may create its own health problems. Regular exercise helps support cardiovascular fitness, metabolic health, healthy body weight and overall wellbeing. These factors are also important for protecting kidney health over the long term. For someone with one kidney, the goal should therefore be to balance the benefits of exercise with the potential risk associated with a particular activity.
What Should Athletes With One Kidney Remember?
If you have one functioning kidney and want to play sports, consider the following:
- Get your kidney function checked regularly.
- Monitor your blood pressure.
- Discuss protein in the urine with your doctor if detected.
- Tell your doctor what sport or activity you want to participate in.
- Understand the risks associated with contact and high-impact activities.
- Follow sport-specific safety recommendations.
- Do not assume protective equipment completely eliminates the risk of injury.
- Seek medical attention after a significant blow to the abdomen or flank.
Having one kidney does not automatically mean giving up sports. For many people, regular physical activity can and should remain part of a healthy lifestyle. The key is individual risk assessment rather than blanket restrictions. Athletes should consider their kidney health, medical history and the type of sport they want to play before making a decision. As Dr Anandh emphasises, a solitary kidney should encourage informed risk management, not immediate exclusion from an active life
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.