Dirt bikes and all terrain vehicles: the real threat to pediatric kidneys.
OBJECTIVE
Recent reviews show that bicycles are the major cause of significant renal injury with few injuries occurring during contact sports. All-terrain vehicles are also responsible for significant pediatric renal trauma. We determined whether dirt bikes and all-terrain vehicles cause more significant renal injuries than contact sports.


METHODS
A retrospective review of our pediatric trauma database revealed 115 consecutive patients treated for renal trauma from 2000 to 2005. A total of 20 bicycle injuries occurred, including 6 on dirt bikes. A total of 13 all-terrain vehicle injuries occurred, including 4 involving rollovers. A total of 12 contact sport injuries occurred, including 2 during pick-up games. The mean grade of renal injury was compared among the mechanisms, with grades III-V considered high grade.


RESULTS
In descending order of renal injury the mechanisms were dirt bike (2.8), all-terrain vehicle rollover (2.8), bicycle (2.3), all-terrain vehicle (2.1), contact sports (1.8) and organized contact sports (1.4). Dirt bikes and all-terrain vehicle rollovers caused significantly greater renal trauma than organized contact sports (2.8 vs 1.4, p = 0.007 and 0.02, respectively), whereas overall bicycle and all-terrain vehicle accidents resulted in similar renal trauma grades compared to those of all contact sports. The 2 high grade renal injuries during contact sports occurred during pick-up football games without protective gear.


CONCLUSIONS
Physician advice regarding children with a solitary kidney should include avoiding dirt bikes and all-terrain vehicles. Efforts to limit all-terrain vehicle use in children younger than 16 years would decrease the risk of significant renal injury in this population more effectively than limiting contact sports participation.
Wu
Hsi-Yang
HY
Department of Pediatric Urology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. wuhy@chp.edu
Gaines
Barbara A
BA
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000704:Analysis of Variance; D001265:Athletic Injuries / Q000453:epidemiology*; D001642:Bicycling / Q000293:injuries*; D005260:Female; D006801:Humans; D007668:Kidney / Q000293:injuries*; D008297:Male; D015541:Off-Road Motor Vehicles; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology