Pubertal growth and final height in children with chronic renal failure on conservative treatment

In order to evaluate the pattern of pubertal growth in children with chronic renal failure (CRF) and its impact on the progression of renal impairment, the auxological data relating to ten boys and five girls with CRF were collected from the beginning to the end of puberty and compared with creatinine clearance (CCr) over the same period. The progression of renal impairment was evaluated as a regression line by plotting CCr by age before and after puberty. The magnitude (10.6 cm/year in males and 10.1 cm/year in females) and timing of peak height velocity (PHV) (13.6 and 11.3 years, respectively) were normal, as was the duration of puberty calculated as the interval between PHV and final height (FH). The slope of the mean regression line during the 5 years before and after PHV was respectively -1.1 +/- 4.2 and -3.7 +/- 3.2 (p <0.05, Mann-Whitney test for non-parametric data). In conclusion, the boys showed a slight impairment in FH (-0.37 SDS), which was more severe in the girls who lost their growth potential in early childhood; the height increases and PHV-FH time intervals were similar to those observed in healthy children (p = NS for all of the considered variables). As the loss of renal function was greater in the post-PHV than prepubertal period, puberty per se may play a role in accelerating the decline in the glomerular filtration rate. This possibility deserves further investigation.