Vol 62, No 3 (2010)
Case report
Published online: 2010-12-06
Seafarer with solitary, well-functioning kidney - fit for service at sea without restrictions?
IMH 2010;62(3):185-187.
Abstract
A 20-year-old, healthy man, who four years earlier had lost a kidney in a skiing accident,
applied for a medical fitness certificate for service on board German flag vessels. Under reference
to national and international regulations he was initially turned down, but attained permission
to sail on appeal. We discuss the justification of denying persons with a single, well-functioning
kidney the opportunity to work at sea, conclude that there is no good reason to refuse
a fitness certificate, and propose to change national and international regulations accordingly.
Keywords: fitness of seafarerssingle kidneycase reportassessment proposal
References
- Regulation on Medical Fitness for Service at Sea. http://www.bgverkehr.de/ser vice/downloads/ship-safety-division/medical-service/regulations. (05.05.2004).
- nternational Labour Organization, Guidelines for Conducting Pre-sea and Periodic Medical Fitness Examinations for Seafarers. http://www.ilo.org/public/ /english/dialogue/sector/techmeet/ilowho97/index.htm (1997).
- Grinsell MM, Showalter S, Gordon KA, et al. Single kidney and sports participation: perception versus reality. Pediatrics. 2006; 118(3): 1019–1027.
- Rice SG. American Academy of Pediatrics Council on Sports Medicine and Fitness. Medical conditions affecting sports participation. Pediatrics. 2008; 121(4): 841–848.
- Diokno E, Rowe D. Medical and orthopedic conditions and sports participation. Pediatr Clin North Am. 2010; 57(3): 839–847.
- Mandell J, Peters CA, Estroff JA, et al. Human fetal compensatory renal growth. J Urol. 1993; 150(2 Pt 2): 790–792.
- Sanna-Cherchi S, Ravani P, Corbani V, et al. Renal outcome in patients with congenital anomalies of the kidney and urinary tract. Kidney Int. 2009; 76(5): 528–533.
- Argueso LR, Ritchey ML, Boyle ET, et al. Prognosis of children with solitary kidney after unilateral nephrectomy. J Urol. 1992; 148(2 Pt 2): 747–751.
- Argueso LR, Ritchey ML, Boyle ET, et al. Prognosis of patients with unilateral renal agenesis. Pediatr Nephrol. 1992; 6(5): 412–416.
- Zaffanello M, Brugnara M, Zuffante M, et al. Are children with congenital solitary kidney at risk for lifelong complications? A lack of prediction demands caution. Int Urol Nephrol. 2009; 41(1): 127–135.
- Narkun-Burgess DM, Nolan CR, Norman JE, et al. Forty-five year follow-up after uninephrectomy. Kidney Int. 1993; 43(5): 1110–1115.
- Fehrman-Ekholm I, Elinder CG, Stenbeck M, et al. Kidney donors live longer. Transplantation. 1997; 64(7): 976–978.
- Holdaas H, Hartmann A, Leivestad T, et al. Mortality of kidney donors during 32 years of observation. J Am Soc Nephrol. 1997; 8: 685A.
- Hartmann A, Fauchald P, Westlie L, et al. The risk of living kidney donation. Nephrol Dial Transplant. 2003; 18(5): 871–873.
- Kasiske BL, Ma JZ, Louis TA, et al. Long-term effects of reduced renal mass in humans. Kidney Int. 1995; 48(3): 814–819.
- Ibrahim HN, Foley R, Tan L, et al. Long-term consequences of kidney donation. N Engl J Med. 2009; 360(5): 459–469.
- Spital A, Jacobs C. Life insurance for kidney donors: another update. Transplantation. 2002; 74(7): 972–973.
