Pubertal development in children with chronic kidney disease

  title={Pubertal development in children with chronic kidney disease},
  author={Dieter Haffner and Miroslav Zivicnjak},
  journal={Pediatric Nephrology},
Impairment of pubertal growth and sexual maturation resulting in reduced adult height is an significant complication in children suffering from chronic kidney disease (CKD). Delayed puberty and reduced pubertal growth are most pronounced in children with pre-existing severe stunting before puberty, requiring long-term dialysis treatment, and in transplanted children with poor graft function and high glucocorticoid exposure. In pre-dialysis patients, therapeutic measures to improve pubertal… 

Growth in children on kidney replacement therapy: a review of data from patient registries

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  • Medicine, Biology
    American journal of kidney diseases : the official journal of the National Kidney Foundation
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Puberty is typically assessed by clinical evaluation of Tanner stage, with pubertal onset defined as transition from stage 1 to stage 2 (thelarche in girls and testicular enlargement in boys).

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This Evidence-Based Guideline developed by members of the European Society for Paediatric Nephrology CKD-MBD, Dialysis and Transplantation working groups presents clinical practice recommendations for the use of growth hormone in children with chronic kidney disease on dialysis and after renal transplantation.

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Although delayed puberty is more common in children with renal disease, precocious puberty can also be seen and Evaluation of growth and puberty should be part of the routine care for all children following kidney transplantation.

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The causes and assessment tools of growth and nutrition while providing a summary of state of the art therapies for these co-morbidities of pediatric CKD are summarized.

Complications of Chronic Kidney Disease in Adolescents

  • E. KuJ. Kwok
  • Medicine, Psychology
    Adolescents with Chronic Kidney Disease
  • 2018
There is a paucity of literature focused exclusively on adolescent-aged children with chronic kidney disease (CKD), and it is vital for caregivers to take into account these developmental changes to ensure optimal long-term health and quality of life for adolescents with CKD.

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The age of starting Estrogen replacement therapy as a key parameter for reaching near normal Final Height (FH) in Chronic Kidney Disease (CKD) girls with growth retardation is investigated and recommend starting EE from 11 yrs.

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Leptin receptor levels < 0.90 ng/mL and hyperprolactinemia are associated with the development of PD in male adolescents with CKD and their relationship with PD with a 1-y follow-up period.



Effect of renal transplantation in childhood on longitudinal growth and adult height.

RTx in children with ESRD induces moderate catch-up growth during the prepubertal growth period, however, final height is reduced in about one third of patients due to the reduced pubertal height gain and preexisting height deficit at the time of RTx.

Factors predicting the near-final height in growth hormone-treated children and adolescents with chronic kidney disease.

Long-term GH therapy of CKD patients in prepubertal and pubertal age results in an increased adult height, but response is diminished in patients on dialysis and/or with severely delayed puberty.

Pubertal Growth in Chronic Renal Failure

The data indicate that most patients reaching end-stage renal failure before or during puberty irreversibly lose growth potential during this period, and Renal transplantation did not consistently improve pubertal growth.

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Growth impairment shows an age-dependent pattern in boys with chronic kidney disease

A specific age-dependent pattern of physical growth was identified in pediatric male CKD patients and should be considered in the evaluation of individual growth and the assessment of treatment efficacy such as rhGH therapy.

Alterations in growth hormone secretion and clearance in peripubertal boys with chronic renal failure and after renal transplantation. Cooperative Study Group of Pubertal development in Chronic Renal Failure.

To elucidate the endocrine mechanisms underlying the pubertal growth failure observed in patients with chronic renal failure (CRF), we used deconvolution analysis to estimate the rates of GH

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Testosterone esters advance skeletal maturation more than growth in short boys with chronic renal failure and delayed puberty

Testosterone therapy was effective in developing sex characteristics, but endogenous pubertal development was not stimulated and growth velocity was increased, but the effect on growth was more than outweighed by bone age acceleration.

Short Stature in Chronic Kidney Disease Treated with Growth Hormone and an Aromatase Inhibitor

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Growth in children on renal replacement therapy: a shrinking problem?

The gains made in growth and maturation in pediatric patients with ESRD in recent decades are reported, particularly in Germany, perhaps reflecting improvements in the quality of care for children with kidney disease worldwide.