title: Puberty is associated with increased deterioration of renal function in patients with CKD: data from the ItalKid Project.
abstract: OBJECTIVE
  To analyse the timing of end stage renal disease in children with chronic kidney disease (CKD).
  
  
  METHODS
  A population-based cohort study.
  
  
  METHODS
  A nationwide registry (ItalKid Project) collecting information on all patients with CKD aged <20 years.
  
  
  METHODS
  935 children with CKD secondary to renal hypodysplasia with or without urologic malformation. In a subgroup of patients (n=40) detailed pubertal staging was analysed in relation to CKD progression.
  
  
  METHODS
  Kidney survival (KS) was estimated using renal replacement therapy (RRT) as the end-point. Puberty was staged by identifying the pubertal growth spurt.
  
  
  RESULTS
  A non-linear decline in the probability of KS was observed, with a steep decrease during puberty: the probability of RRT was estimated to be 9.4% and 51.8% during the first and second decades of life, respectively. A break-point in the KS curve was identified at 11.6 and 10.9 years of age in male and female patients, respectively.
  
  
  CONCLUSIONS
  The present analysis suggests that puberty is associated with increased deterioration of renal function in CKD. The mechanism(s) underlying this unique and specific (to children) pattern of progression have not yet been identified, but it may be that sex hormones play a role in this puberty-related progression of CKD.
authors: Unit of Pediatric Nephrology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors: Gianluigi
authors: G
authors: Ardissino
authors: Sara
authors: S
authors: Testa
authors: Valeria
authors: V
authors: Daccò
authors: Fabio
authors: F
authors: Paglialonga
authors: Sara
authors: S
authors: Viganò
authors: Cristina
authors: C
authors: Felice-Civitillo
authors: Francesco
authors: F
authors: Battaglino
authors: Alberto
authors: A
authors: Bettinelli
authors: Andrea
authors: A
authors: Bordugo
authors: Valeria
authors: V
authors: Cecchetti
authors: Salvatore
authors: S
authors: De Pascale
authors: Angela
authors: A
authors: La Manna
authors: Salvatore
authors: S
authors: Li Volti
authors: Silvio
authors: S
authors: Maringhini
authors: Giovanni
authors: G
authors: Montini
authors: Marco
authors: M
authors: Pennesi
authors: Leopoldo
authors: L
authors: Peratoner
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D012739:Gonadal Steroid Hormones / Q000378:metabolism; D006801:Humans; D007223:Infant; D007668:Kidney / Q000502:physiology*; D008297:Male; D011627:Puberty / Q000502:physiology*; D051436:Renal Insufficiency, Chronic / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D017582:Renal Replacement Therapy / Q000379:methods*; D012737:Sex Factors; D055815:Young Adult
chemical_list: D012739:Gonadal Steroid Hormones