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Related Experiment Videos

Growth and endocrine function after renal transplantation.

L Rees1, S A Greene, P Adlard

  • 1Evelina Children's Hospital, United Medical School, London.

Archives of Disease in Childhood
|November 1, 1988
PubMed
Summary

Pediatric renal transplant patients on long-term steroids experienced delayed puberty and short stature. Steroid treatment impacted growth hormone and gonadotropin secretion, affecting adult height potential.

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Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Growth and Development

Background:

  • Renal transplantation is a life-saving procedure for children with end-stage renal disease.
  • Immunosuppressive therapy, including corticosteroids, is crucial post-transplant but can have significant side effects.
  • Altered physical development and growth disturbances are known complications in pediatric transplant recipients.

Purpose of the Study:

  • To assess longitudinal height data and physical development in children post-renal transplantation.
  • To investigate the impact of immunosuppressive therapy on pubertal development and hormonal profiles.
  • To identify potential causes of short stature and delayed maturation in this cohort.

Main Methods:

  • Longitudinal assessment of height and physical development in 45 boys and 34 girls post-renal transplantation.

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  • Administration of alternate-day steroids combined with azathioprine or cyclosporin A for immunosuppression.
  • Analysis of overnight hormone profiles in adolescent subjects with short stature or maturational delay.

    • Main Results:

    • Significant increase in growth velocity observed in prepubertal children after transplantation.
    • Growth velocity declined at the expected pubertal spurt age, with delayed secondary sexual characteristics.
    • Hormone profiles revealed blunted growth hormone and gonadotropin pulsatility in adolescents with short stature or delayed maturation.

    Conclusions:

    • Long-term steroid treatment following renal transplantation likely induces delayed puberty and endocrine disturbances.
    • Impaired growth acceleration during adolescence contributes to short stature, potentially impacting adult height.
    • Further research is warranted to optimize immunosuppressive regimens and mitigate long-term growth complications.