title: Pubertal development in children with chronic kidney disease.
abstract: 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 are limited and mainly based on the preservation of renal function and the use of growth hormone treatment. In patients with end-stage CKD, early kidney transplantation with steroid withdrawal within 6 months of renal transplantation allows for normal pubertal development in the majority of patients. This review focuses on the underlying pathophysiology and strategies for improving height and development in these patients.
authors.affiliation: Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany. dieter.haffner@mh-hannover.de.
authors.forename: Dieter
authors.initials: D
authors.lastname: Haffner
authors.affiliation: Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Zivicnjak
mesh_terms: D000293:Adolescent; D000328:Adult; D001827:Body Height / Q000187:drug effects; D002648:Child; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006084:Graft Rejection / Q000517:prevention & control; D006130:Growth Disorders / Q000188:drug therapy / Q000209:etiology*; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D011628:Puberty, Delayed / Q000188:drug therapy / Q000209:etiology*; D006435:Renal Dialysis / Q000009:adverse effects; D012737:Sex Factors; D012741:Sexual Maturation; D013739:Testosterone / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D019382:Human Growth Hormone; D013739:Testosterone
keywords: Chronic kidney disease; Dialysis; Glucocorticoids; Growth failure; Growth hormone; Hypogonadism; Pubertal development; Transplantation