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Kidney Week

Abstract: TH-PO756

Pubertal Delay and Impact on Short Stature Among Girls with CKD

Session Information

  • Pediatric CKD
    November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Kim, Hannah, Johns Hopkins University, Baltimore, Maryland, United States
  • Ng, Derek, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Matheson, Matthew, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Atkinson, Meredith A., Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Warady, Bradley A., Children's Mercy Kansas City, Kansas City, Missouri, United States
  • Furth, Susan L., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Ruebner, Rebecca, Johns Hopkins University, Baltimore, Maryland, United States
Background

Children with chronic kidney disease (CKD) have delays in normal growth and pubertal development. We aimed to describe factors associated with delayed puberty including short stature among children with CKD.

Methods

A prospective cohort study was conducted using the Chronic Kidney Disease in Children (CKiD) study. Delayed puberty was defined as menarche at age 15 years or older. Short stature was defined as last available height 2 standard deviations below projected mid-parental height. Chi-squared and Wilcoxon rank-sum tests were used to assess factors associated with delayed menarche.

Results

Median age at menarche was 12 years (IQR, 12 to 14 years, Figure). 10% had delayed menarche. African American race, lower eGFR, and longer CKD duration at time of menarche were associated with delay in menarche (p < 0.05), and girls with delayed menarche had lower height and weight percentiles (p<0.05, Table). 61% of girls with delayed menarche had short stature compared to only 35% of girls without delayed menarche (p=0.03).

Conclusion

Median age at menarche is similar among girls with CKD and healthy girls. However, 10% of girls with CKD have delayed menarche, which may negatively impact final adult height.

 Normal Menarche
n = 124
Delayed Menarche
n = 21
P-value
Sociodemographic   
Age at Menarche (yrs), median (IQR)12 (12,13)15.7 (15,17.4)<0.001
African American Race15 (12.1%)6 (28.6%)0.047
Abnormal Birth History45 (36.3%)9 (42.9%)0.621
Kidney Disease Characteristics   
Age Onset (yrs), median (IQR)0 (0,3)0 (0,9.5)0.672
Duration of CKD at Menarche (yrs), median (IQR)12 (8.5,13.0)15 (7.9,16.3)<0.001
Glomerular Disease35 (28.2%)7 (33.3%)0.633
eGFR at Menarche (ml/min/1.73m2), median (IQR)47.8 (32.6,64.0)30.6 (25.3,37.1)0.007
Growth   
Weight Percentile at Menarche, median (IQR)52.4 (24.3,81.6)14.1 (2.8,74.1)0.007
Height Percentile at Menarche, median (IQR)32.8 (8.4,65.8)10.4 (2.5,26.3)0.003

Menarche in NHANES versus CKiD

Funding

  • NIDDK Support