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Sexual maturity of children on regular hemodialysis Role of testosterone and estradiol, a tertiary multicenter experience

• 2022
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Authors Ahmed S. Abdel-Halim Soliman, MDa , Naglaa M. Kamal, MDb,∗ , Mohmed W. Abukhatwah, MDc , Ghada M. El Mashad, MDa , Iman R. Abd El Gowaad, MDd , Yasser A. Halabi, MBBChc , Saad A. Alalyani, MBBChc , Shahad A. Qari, MBBChc , Wesam E. Afifi, MDa
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Abstract
A big problem is the delayed growth and sexual maturity in children with chronic kidney disease (CKD) with the consequent reduction
in adults’ height. Testosterone and estradiol have significant physiologic changes in children suffering from CKD, resulting in delayed
puberty. We aim to assess blood levels of these hormones in patients with CKD-5 on regular hemodialysis.
One hundred-six participants were enrolled in the current study, 56 of whom had CKD on hemodialysis 3 times a week 4 hours per
session, and 60 healthy age- and gender-matched children acted as controls. Full history was taken, and a clinical review was
performed on both patients and controls. The pubertal assessment was performed according to Tanner’s classification and
laboratory investigations of total and free serum (s.) testosterone in boys and s.estradiol in girls.
Patients’ weight and height were considerably lower than controls. The free and total s.testosterone of patients were significantly
reduced. The same applies to s.estradiol levels which were substantially reduced in comparison to controls. In both patients and
controls, Tanner staging & male total s.testosterone levels and female s.estradiol levels had significant positive associations. There
was a negative association between the sex hormones levels and the disease’s and dialysis duration in the patients’ group.
S.testosterone and s.estradiol levels were significantly low in CKD patients on dialysis and were positively correlated with delayed
pubertal growth observed in those patients.