Abstract
Pubertal development is frequently delayed and disturbed in patients with CRF. Renal transplantation may be followed by rapid sexual maturation. Studies in adult uremic patients have demonstrated a loss of pulsatile gonadotrophin secretion, suggesting a hypothalamic lesion. We hypothesized that a similar defect might be responsible for the disorders of puberty observed in CRF. We examined the physiological nocturnal gonadotrophin secretion in 6 male and 2 female patients aged 11.6-19.6 yrs with end-stage CRF (5 treated by dialysis, 3 transplanted). Appearance of pubertal signs was delayed in all but one patient. Blood was drawn every 15-20 min for a period of 8-12 hrs. In none of the dialysed patients a nocturnal rise of serum LH was observed, and pulsatility was reduced to a mean of 1.4 pulses/ study, whereas the transplanted patients demonstrated a normal rise and pulsatility of LH (mean: 4.3 pulses/ study). No pulsatile FSH secretion was observed in any profile. We conclude that pulsatile GnRH secretion is disturbed in children with end-stage CRF which may be the major cause for the delay of pubertal development. Gonadotrophin pulsatility seems to be restored by successful renal transplantation.
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Schaefer, F., Stanhope, R., Scheil, H. et al. 118 PULSATILE GONADOTROPHIN SECRETION IN PUBERTAL CHILDREN WITH CHRONIC RENAL FAILURE (CRF). Pediatr Res 24, 536 (1988). https://doi.org/10.1203/00006450-198810000-00139
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DOI: https://doi.org/10.1203/00006450-198810000-00139