Nephrology Diving Permission for children with renal disease

Background: Today, diving has been added to the list of marine recreations in Iran. Children are very eager to experience excitement and discover the unknown world around them. According to common electrolyte disorders, inappropriate Blood pressure and subsequent consequences in children with renal disease, it's important to know whether they can experience diving or under what conditions they are allowed to dive. Method: The keywords related to renal disease and diving were searched in studies published from ۲۰۰۵ to ۲۰۲۵ in Scopus, PubMed, Science Direct, and Google Scholar, resulting in ۲۴۵ articles, of which ۱۰۶ articles were reviewed. Results: Children with renal disease, due to their careful adjustment of specialized treatment such as Dialysis or their medical equipment such as vascular catheters, as well as the side effects of medications, have certain restrictions despite not having a contradiction. The most important reasons include: • Hydration status, because they are more prone to volume overload. However, if the urine output is normal, they aren't contraindicated for diving. • Potassium, which is more than ۹۰% is excreted through the kidneys, so hyperkalemia is common in CKD, and they are contraindicated for diving, due to the possibility of adverse cardiac events during diving. •Uremia & Acidosis, if the patients are stable, such as immediately after dialysis, they are allowed to dive. • Renal Transplantation, who are potentially at risk of hypertension, medical side effects, and under immunosuppression medications. Diving isn't permitted due to the aquatic environment being full of dangerous microorganisms and pressure changes during diving. •Renal stone, which diving increases the likelihood of their passing, due to buoyancy diuresis, and decisions should be made based on hydration status before diving. Surgical manipulations, where diving is permitted ۲-۴ weeks after a closed kidney biopsy and after complete wound healing, and if there is no risk of urinary leakage or bleeding. AV fistula, which are allowed to develop if they don't have an artificial channel (Gore-Tex grafts) Diuretics may affect their tolerance to sudden changes in situation, causing lightheadedness and fainting, so diving is contraindicated. Conclusion: Children with renal disease can dive only if they are stable and if prepared in advance for sudden pressure changes.

کلیدواژه ها:

Diving ، renal disease ، electrolyte imbalance ، renal stone