Abstract
We have investigated children following renal transplantation (PTX) and with steroid sensitive nephrotic syndrome (SSNS), both groups receiving long term alternate day steroid therapy; in children with SSNS frequent relapses necessitated periodic dose increases. Height SDS was below the population mean; PTX (n=10) -1.4(1.3), p<0.05; SSNS (n=29) -0.82(0.22), p<0.001. In children with SSNS Ht SDS correlated with duration of therapy (r=-0.63, p< 0.005), but not with relapse rate. We measured overnight endocrine function in 5 severely growth affected subjects (2 PTX age 14.4 and 17.6 yr; 3 SSNS age 14.1, 15.1 and 17.1 yr). Blood samples for GH, prolactin, FSH, LH, testosterone and cortisol were obtained every 15-20 min from 20.00 hr until 07.00 hr. Sleep state was monitored by continuous portable EEG. Abnormal profiles were seen in all 5 subjects. In the PTX adolescents there was no rise in GH or prolactin and no pulsatility of gonadotrophins. In the SSNS adolescents the patterns were consistent with pubertal delay (low amplitude and frequency pulses of GH and LH). These preliminary results indicate two different mechanisms of endocrine dysfunction which may account for growth failure and maturation delay in children with renal disease treated by long term steroids.
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Greene, S., Rees, L., Adlard, P. et al. ABNORMAL OVERNIGHT HORMONE PROFILES IN ADOLESCENTS WITH RENAL DISEASE RECEIVING LONG TERM STEROID THERAPY. Pediatr Res 20, 1204 (1986). https://doi.org/10.1203/00006450-198611000-00184
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DOI: https://doi.org/10.1203/00006450-198611000-00184