[The epiphyseal plate in hemodialysis, peritoneal dialysis and following kidney transplantation].
We evaluated growth, maturity of the skeleton and formation of skeletal deformities and epiphysiolysis of the femoral head in 22 children with end-stage renal failure undergoing haemodialysis, CAPD (continuous ambulatory peritoneal dialysis) and after kidney transplantation. We found growth retardation and disturbances of skeletal maturity in 64% of the children and skeletal deformities in 45%. Children undergoing haemodialysis showed a higher rate of retardation in growth and skeletal maturity than those undergoing CAPD and kidney transplantation. A high level of cortisone and frequent rejections after renal transplantation also lead to poorer growth and skeletal maturity. Children suffering from congenital renal dysfunction showed a higher rate of skeletal deformities. During haemodialysis the level of PTH (parathyroid hormone) was significantly higher than during CAPD and after renal transplantation. Epiphysiolysis capitis femoris lenta was found in 3 children, two of which occurred on both sides. These children had a significantly higher average level of PTH than the other 19.
Fink
B
B
Orthopädische Klinik und Poliklinik der Heinrich-Heine-Universität Düsseldorf.
Schneider
T
T
Wilcke
C
C
von Lilien
T
T
Rüther
W
W
D000293:Adolescent; D000365:Age Determination by Skeleton; D002648:Child; D002675:Child, Preschool; D005260:Female; D006130:Growth Disorders / Q000209:etiology* / Q000473:pathology; D006132:Growth Plate / Q000473:pathology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D016030:Kidney Transplantation / Q000009:adverse effects; D008137:Longitudinal Studies; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects; D006435:Renal Dialysis / Q000009:adverse effects; D017582:Renal Replacement Therapy / Q000009:adverse effects*
D010281:Parathyroid Hormone