ABSTRACT
This chapter considers responses in the individual who has only a single kidney, looking at the advice that the clinician should offer to the young athlete with only one kidney. It aims to weigh conflicting opinions on the risks of renal injury associated with an active lifestyle and to suggest principles that should guide the clinical management of children with a single kidney. A person with two healthy kidneys usually has a substantial renal reserve, and normal function is quite well maintained even after nephrectomy. However, the functional margin is inevitably smaller for a person who begins with a single kidney, and the initial health of the kidney then becomes a significant issue. A solitary kidney also has a more than normal vulnerability to irreversible damage from heat stress, and the temperature limits that are set for prolonged bouts of endurance exercise should be observed particularly carefully in those with a single kidney.
