Effect of childhood kidney transplantation on puberty

Ghanem, Mohamad E.; Emam, Mohamad E.A.; Albaghdady, Laila A.; Bakr, N.I.; Helal, Ahmed H.; Sadek, Ehab E.; Sobh, Mohamad

doi:10.1016/j.fertnstert.2009.12.069

Cited by 11 publications

(4 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Delayed puberty has been reported in several studies on pediatric RTx patients [73,74]. In a recent report by Tainio et al, children who underwent RTx at a young age (most patients <2 years at RTx) had quite normal puberty and reached it earlier than those transplanted at later age (12.3 vs. 13.4 years) [69].…”

Section: Pubertal Developmentmentioning

confidence: 95%

Renal transplantation in infants

2015

View full text Add to dashboard Cite

Renal transplantation (RTx) has become an accepted mode of therapy in infants with severe renal failure. The major indications are structural abnormalities of the urinary tract, congenital nephrotic syndrome, polycystic diseases, and neonatal kidney injury. Assessment of these infants needs expertise and time as well as active treatment before RTx to ensure optimal growth and development, and to avoid complications that could lead to permanent neurological defects. RTx can be performed already in infants weighing around 5 kg, but most operations occur in infants with a weight of 10 kg or more. Perioperative management focuses on adequate perfusion of the allograft and avoidance of thrombotic and other surgical complications. Important long-term issues include rejections, infections, graft function, growth, bone health, metabolic problems, neurocognitive development, adherence to medication, pubertal maturation, and quality of life. The overall outcome of infant RTx has dramatically improved, with long-term patient and graft survivals of over 90 and 80 %, respectively.

show abstract

Section: Pubertal Developmentmentioning

confidence: 95%

Renal transplantation in infants

2015

View full text Add to dashboard Cite

show abstract

“…The majority of children achieve normal puberty following transplant, but many may have a delayed onset and shortened duration of pubertal growth spurt, which is predicted by delayed bone age compared to their chronological age. 50,51…”

Section: Pubertymentioning

confidence: 99%

Long-Term Outcomes of Kidney Transplantation in Children

Winterberg

Garro

2019

Pediatric Clinics of North America

View full text Add to dashboard Cite

“…In young women, delayed menarche is associated with lower bone density at the lumbar spine and femoral neck, and declines further with each year that menarche is delayed (27). A study of pediatric ESRD patients showed that age at menarche was significantly positively correlated with uremia duration (28). In boys with CKD and delayed puberty, treatment with exogenous testosterone resulted in development of sex characteristics and accelerated bone age that exceeded growth velocity, resulting in lost growth potential (29).…”

Section: Ckd-related Bone and Mineral Changesmentioning

confidence: 99%

“…A study assessed sexual maturation of pediatric kidney transplant recipients by Tanner staging and found that the age of onset of puberty was significantly delayed in the transplant recipients compared with controls (28). Delayed sexual maturation was present in 22.2% of girls and 19.1% of boys, and was related to lower levels of sex steroids in these transplant recipients.…”

Section: Post-transplantmentioning

confidence: 99%

Optimization of Bone Health in Children before and after Renal Transplantation: Current Perspectives and Future Directions

Sgambat

Moudgil

2014

Front. Pediatr.

View full text Add to dashboard Cite

The accrual of healthy bone during the critical period of childhood and adolescence sets the stage for lifelong skeletal health. However, in children with chronic kidney disease (CKD), disturbances in mineral metabolism and endocrine homeostasis begin early on, leading to alterations in bone turnover, mineralization, and volume, and impairing growth. Risk factors for CKD–mineral and bone disorder (CKD–MBD) include nutritional vitamin D deficiency, secondary hyperparathyroidism, increased fibroblast growth factor 23 (FGF-23), altered growth hormone and insulin-like growth factor-1 axis, delayed puberty, malnutrition, and metabolic acidosis. After kidney transplantation, nutritional vitamin D deficiency, persistent hyperparathyroidism, tertiary FGF-23 excess, hypophosphatemia, hypomagnesemia, immunosuppressive therapy, and alteration of sex hormones continue to impair bone health and growth. As function of the renal allograft declines over time, CKD–MBD associated changes are reactivated, further impairing bone health. Strategies to optimize bone health post-transplant include healthy diet, weight-bearing exercise, correction of vitamin D deficiency and acidosis, electrolyte abnormalities, steroid avoidance, and consideration of recombinant human growth hormone therapy. Other drug therapies have been used in adult transplant recipients, but there is insufficient evidence for use in the pediatric population at the present time. Future therapies to be explored include anti-FGF-23 antibodies, FGF-23 receptor blockers, and treatments targeting the colonic microbiota by reduction of generation of bacterial toxins and adsorption of toxic end products that affect bone mineralization.

show abstract

Effect of childhood kidney transplantation on puberty

Cited by 11 publications

References 28 publications

Renal transplantation in infants

Renal transplantation in infants

Long-Term Outcomes of Kidney Transplantation in Children

Optimization of Bone Health in Children before and after Renal Transplantation: Current Perspectives and Future Directions

Contact Info

Product

Resources

About