ISSN:
1432-198X
Keywords:
Puberty
;
Dialysis
;
Transplantation
;
Chronic renal failure
;
Hormones
;
Bioassay
;
Hypothalamo-pituitary axis
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Delayed or arrested pubertal development is common in children with chronic renal failure (CRF). Normal puberty is initiated by the onset of episodic nocturnal secretion of luteinizing hormone (LH) containing an increasing proportion of bioactive hormone. To test the functional integrity of the hypothalamo-pituitary axis in CRF we measured immunoreactive (i-LH) and bioactive (bio-LH) plasma LH concentrations at 15-min intervals from 2000 to 0700 hours in 65 pubertal patients aged 10–23 years [46 boys/19 girls; 20 on conservative treatment (CT), 13 on dialysis (D), 32 with transplants (TP)]. i-LH was determined by radio-immunoassay and bio-LH by a mouse Leydig cell assay. Peak detection was performed by the cluster analysis computer programme. The mean (±SD) number of i-LH (in both sexes) and bio-LH pulses (in boys) per profile, and the mean peak area of i-LH (in both sexes) and bio-LH (in girls) were higher in TP than in CT or D patients. The ratio of bio-LH to i-LH increased during puberty in CT (G1 vs G4/5, 0.3±0.5 vs 1.8±0.,4) and TP (0.6±0.7 vs 1.8±0.7) but remained low in male D patients (0.4±0.7 vs 1.1±0.8). The ratios were subnormal, however, even in mature TP patients compared with healthy adults. The bio-LH/i-LH ratio and the bio-LH peak area best predicted integrated nocturnal testosterone concentrations in TP but not in uraemic male patients. The data demonstrate that in adolescents with CRF, secretion of LH is tonic rather than pulsatile and bioactivity of the hormone is reduced. Both phenomena may contribute to the delay of sexual maturation. In TP patients the pulsatile pattern of LH secretion is restored and bioactivity increases. Corticosteroid treatment may be responsible for the incomplete normalization of the bio-LH/i-LH ratio in CRF.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF01453703
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