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Delayed menarche in girls with chronic kidney disease and the association with short stature

Pediatric Nephrology volume 35, pages 1471–1475 (2020)Cite this article

Abstract

Background

Children with chronic kidney disease (CKD) have delays in normal growth and pubertal development. We describe factors associated with delayed menarche and the association of delayed menarche with short stature in girls with CKD.

Methods

Two hundred eighty-seven girls with CKD onset prior to menarche within the Chronic Kidney Disease in Children (CKiD) cohort were studied. Delayed menarche was defined as menarche at age 15 years or older; short stature was defined as last available height 2 standard deviations below projected adult height. Kaplan-Meier cumulative incidence function was used to estimate median age at menarche. Chi-squared and Wilcoxon rank-sum tests were used to assess factors associated with delayed menarche. Chi-squared test was used to evaluate the association between delayed menarche and short stature.

Results

Among 287 girls, 68 enrolled with prevalent menarche, 131 were observed to have incident menarche, and 88 were pre-menarchal at their last study visit. Median age at menarche was 12 years. Ten percent had delayed menarche. African American race, lower estimated glomerular filtration rate, ever corticosteroid use, and longer CKD duration were associated with delayed menarche (p < 0.05). Girls with delayed menarche had lower height and weight percentiles at the time of menarche (p < 0.05). Sixty-one percent of girls with delayed menarche had short stature compared with only 35% of girls without delayed menarche (p = 0.03).

Conclusion

Median age at menarche is similar among girls with CKD and healthy girls. Ten percent of girls with CKD had delayed menarche and may be at risk for short stature.

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Funding

This work was supported by T32DK007732.

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Affiliations

  1. Division of Pediatric Nephrology, Johns Hopkins University, 200 N Wolfe St Rm 3055, Baltimore, MD, 21218, USA

    Hannah S. Kim, Meredith A. Atkinson & Rebecca L. Ruebner

  2. Department of Epidemiology, Johns Hopkins University, Baltimore, MD, 21218, USA

    Derek K. Ng & Matthew B. Matheson

  3. Division of Pediatric Nephrology, Children’s Mercy Hospital, 2401 Gillham Rd, Kansas City, MO, 64108, USA

    Bradley A. Warady

  4. Division of Pediatric Nephrology, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA

    Susan L. Furth

Authors
  1. Hannah S. Kim
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  2. Derek K. Ng
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  3. Matthew B. Matheson
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  4. Meredith A. Atkinson
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  5. Bradley A. Warady
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  6. Susan L. Furth
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  7. Rebecca L. Ruebner
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Correspondence to Hannah S. Kim.

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Kim, H.S., Ng, D.K., Matheson, M.B. et al. Delayed menarche in girls with chronic kidney disease and the association with short stature. Pediatr Nephrol 35, 1471–1475 (2020). https://doi.org/10.1007/s00467-020-04559-7

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  • DOI: https://doi.org/10.1007/s00467-020-04559-7

Keywords

  • Puberty
  • Menarche
  • Chronic kidney disease
  • Short stature
  • Growth
  • Height