Die Epiphysenfuge bei Hämodialyse, Peritonealdialyse und nach Nierentransplantation

Abstract

We evaluated growth, maturity of the skeleton and formation of skeletal deformities and epiphysiolysis of the femoral head in 22 children with end-stage renal failure undergoing haemodialysis, CAPD (continuous ambulatory peritoneal dialysis) and after kidney transplantation. We found growth retardation and disturbances of skeletal maturity in 64% of the children and skeletal deformities in 45%. Children undergoing haemodialysis showed a higher rate of retardation in growth and skeletal maturity than those undergoing CAPD and kidney transplantation. A high level of cortisone and frequent rejections after renal transplantation also lead to poorer growth and skeletal maturity. Children suffering from congenital renal dysfunction showed a higher rate of skeletal deformities. During haemodialysis the level of PTH (parathyroid hormone) was significantly higher than during CAPD and after renal transplantation. Epiphysiolysis capitis femoris lenta was found in 3 children, two of which occurred on both sides. These children had a significantly higher average level of PTH than the other 19.