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Pubertal development in children with chronic kidney disease
Dieter Haffner1, Miroslav Zivicnjak2
1Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany. dieter.haffner@mh-hannover.de.
Pediatric Nephrology (Berlin, Germany)
|July 29, 2016
Summary
Children with chronic kidney disease (CKD) often experience impaired pubertal growth and reduced adult height. Early kidney transplantation with steroid withdrawal can enable normal pubertal development in most patients.
Area of Science:
- Pediatric Nephrology
- Endocrinology
- Growth and Development
Background:
- Chronic kidney disease (CKD) significantly impacts pubertal growth and sexual maturation in children, leading to reduced adult height.
- This growth impairment is particularly severe in children with pre-existing stunting, those on long-term dialysis, and transplanted patients with poor graft function and high glucocorticoid exposure.
Purpose of the Study:
- To review the pathophysiology of impaired pubertal development in pediatric CKD.
- To explore strategies for improving height and sexual maturation in children with CKD.
Main Methods:
- Literature review focusing on pathophysiology and therapeutic interventions for growth and sexual maturation in pediatric CKD.
- Analysis of outcomes in pre-dialysis, dialysis, and post-kidney transplantation cohorts.
Main Results:
- Therapeutic options for pre-dialysis CKD patients are limited, focusing on renal function preservation and growth hormone treatment.
- Early kidney transplantation followed by prompt steroid withdrawal (within 6 months) facilitates normal pubertal development in most cases.
Conclusions:
- Effective management of pubertal development in pediatric CKD requires a multi-faceted approach.
- Optimizing transplantation protocols, including timely steroid withdrawal, is crucial for achieving normal growth and sexual maturation.
Keywords:
Chronic kidney diseaseDialysisGlucocorticoidsGrowth failureGrowth hormoneHypogonadismPubertal developmentTransplantationMore Related Videos
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