title: Pubertal development is normal in adolescents after renal transplantation in childhood.
abstract: BACKGROUND
  This study was conducted to evaluate the pubertal development in adolescents after renal transplantation (RTx) in childhood.
  
  
  METHODS
  We performed a retrospective review of medical records of 109 RTx recipients (72 males) transplanted at the median age of 4.5 years (range: 0.9-15.8 years). Data on the clinical signs of puberty, growth, bone age, medication, and graft function of 98 patients were analyzed. Furthermore, serum levels of reproductive hormones in 87 patients were assessed to evaluate the progression and outcome of pubertal development.
  
  
  RESULTS
  The age at the onset of puberty averaged 12.7 years (range: 9.4-16.2 years) in 55 males and 10.7 years (range: 8.9-12.7 years) in 29 females. The mean age at menarche was 12.5 years (range: 10.5-14.5 years). Twenty-two percent of the boys and none of the girls had a moderately delayed onset of puberty. Children who underwent RTx before the age of 5 years reached puberty earlier than those transplanted at later age (boys 12.3±1.2 vs. 13.4±1.5 years, P<0.01; girls 10.3±0.9 vs. 11.0±1.0 years, P>0.05). The mean length of puberty was 3.9 and 4.7 years for boys and girls, respectively. The bone age was delayed in practically all, and final height was reached at the mean age of 18.1 and 16.0 years in boys and girls, respectively. Pubertal maturation resulted in acceptable final height and reproductive hormone status in great majority of the patients.
  
  
  CONCLUSIONS
  Pubertal development was normal in all female and most male adolescents after RTx in childhood.
authors.affiliation: Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland. juuso.tainio@helsinki.fi
authors.forename: Juuso
authors.initials: J
authors.lastname: Tainio
authors.forename: Erik
authors.initials: E
authors.lastname: Qvist
authors.forename: Reeta
authors.initials: R
authors.lastname: Vehmas
authors.forename: Kirsi
authors.initials: K
authors.lastname: Jahnukainen
authors.forename: Tuula
authors.initials: T
authors.lastname: Hölttä
authors.forename: Helena
authors.initials: H
authors.lastname: Valta
authors.forename: Timo
authors.initials: T
authors.lastname: Jahnukainen
authors.forename: Hannu
authors.initials: H
authors.lastname: Jalanko
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001827:Body Height; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005387:Finland; D012739:Gonadal Steroid Hormones / Q000097:blood; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D016030:Kidney Transplantation / Q000009:adverse effects / Q000473:pathology / Q000502:physiology*; D008297:Male; D008572:Menarche / Q000502:physiology; D011627:Puberty / Q000502:physiology*; D011628:Puberty, Delayed / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D012189:Retrospective Studies
chemical_list: D012739:Gonadal Steroid Hormones; D007166:Immunosuppressive Agents; D019382:Human Growth Hormone