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 Race | 15 (12.1%) | 6 (28.6%) | 0.047 |
| Abnormal Birth History | 45 (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 Disease | 35 (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