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Pubertal luteinizing hormone levels in children with chronic kidney disease and association with change in glomerular filtration rate

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Abstract

Background

Children with chronic kidney disease (CKD) are at risk for abnormalities in pubertal development. We aimed to describe the timing of pubertal onset by luteinizing hormone (LH) levels and the association between hormonal onset of puberty with changes in GFR.

Methods

Data from the Chronic Kidney Disease in Children (CKiD) study were collected prospectively. GFR was estimated at annual visits and measured by iohexol clearance every other year. LH was measured from stored repository serum samples in a nested sample of 124 participants. Hormonal onset of puberty was defined as LH level greater than or equal to 0.3 IU/L. A mixed effects model with random intercepts and slopes was used to compare the slope of decline of GFR before and after hormonal onset of puberty. The model was adjusted for age, glomerular disease diagnosis, baseline proteinuria on the log scale, and BMI.

Results

Median age at hormonal onset of puberty was 9.9 years (IQR 8.1, 11.9) in girls and 10.2 years (IQR 9.2, 11.0) in boys. The mixed effects model showed faster decline in both estimated GFR and measured GFR in boys after hormonal onset of puberty (p < 0.001), and a similar but attenuated accelerated estimated GFR decline was observed for girls with no difference for measured GFR.

Conclusions

LH levels in the post-pubertal range were observed prior to clinical manifestations of puberty in children with CKD. Hormonal onset of puberty was associated with faster decline in GFR, particularly among boys with CKD.

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Data availability

Data from the Chronic Kidney Disease in Children Cohort Study [(V7 https://doi.org/10.58020/dzq8-ct80] reported here are available for request at the NIDDK Central Repository (NIDDK-CR) website, Resources for Research (R4R), https://repository.niddk.nih.gov/.

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Funding

Data in this manuscript were collected by the Chronic Kidney Disease in children prospective cohort study (CKiD) with clinical coordinating centers (Principal Investigators) at Children’s Mercy Hospital and the University of Missouri—Kansas City (Bradley Warady, MD) and Children’s Hospital of Philadelphia (Susan Furth, MD, PhD), Central Biochemistry Laboratory (George Schwartz, MD) at the University of Rochester Medical Center, and data coordinating center (Alvaro Muñoz, PhD and Derek Ng, PhD) at the Johns Hopkins Bloomberg School of Public Health. The CKiD Study is supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases, with additional funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Heart, Lung, and Blood Institute (U01 DK066143, U01 DK066174, U24 DK082194, U24 DK066116). The CKiD Web site is located at https://statepi.jhsph.edu/ckid. This study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The data and biospecimens from the CKiD study reported here were supplied by the NIDDK Central Repository. This manuscript does not necessarily reflect the opinions or views of the NIDDK Central Repository or the NIDDK. Research reported in this publication was funded by The Children’s Hospital of Philadelphia Pediatric Center of Excellence in Nephrology and the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award number P50DK114786. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Division of Pediatric Nephrology, Weill Cornell Medicine, 505 East 70th St, 3rd floor, New York, NY, 10021, USA

    Hannah S. Kim

  2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Derek K. Ng & Matthew B. Matheson

  3. Division of Pediatric Nephrology, Johns Hopkins University, Baltimore, MD, USA

    Meredith A. Atkinson & Rebecca L. Ruebner

  4. Division of Pediatric Endocrinology, Johns Hopkins University, Baltimore, MD, USA

    Yasmin Akhtar

  5. Division of Pediatric Nephrology, Children’s Mercy Kansas City, Kansas City, MO, USA

    Bradley A. Warady

  6. Pediatric Nephrology, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Susan L. Furth

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  1. Hannah S. Kim
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Correspondence to Hannah S. Kim.

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Kim, H.S., Ng, D.K., Matheson, M.B. et al. Pubertal luteinizing hormone levels in children with chronic kidney disease and association with change in glomerular filtration rate. Pediatr Nephrol 39, 1543–1549 (2024). https://doi.org/10.1007/s00467-023-06210-7

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