Evaluation of Some Puberty-related Hormones Among Children and Adolescents With Chronic Kidney Diseases

NCT ID: NCT05835089

Last Updated: 2023-04-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

50 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-05-31

Study Completion Date

2024-05-31

Brief Summary

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Puberty is the process of transition from childhood into adolescence, signaling the readiness of the human body for reproduction. The Hypothalamic-Pituitary Gonadotropin axis plays the primary role in initiating the puberty, where the hypothalamus secrets gonadotropin releasing hormone (GnRH) in a pulsatile manner, which in turn stimulates the release of luteinizing hormone (LH), and follicle stimulating hormone (FSH) from the anterior lobe of the pituitary gland, and in a final step these hormones stimulate the gonads to release their sex hormones (Testosterone and Estradiol) .

Chronic illnesses can affect this physiological process resulting in delayed puberty . Delayed puberty is defined as the lack of pubertal signs until the age of 13 years in girls, and the age of 14 years in boys. Delayed puberty is classified into two categories according to their cause; central gonadotropin deficiency (hypogonadotropic hypogonadism) and this type comprises delayed puberty due to chronic illness, while the second category of delayed puberty is due to gonadal disorders (hypergonadotropic hypogonadism).

Delayed puberty is common among pediatric patients with chronic kidney disease (CKD) - where glomerular filtration rate (GFR) is less than 60 ml/min per 1.73 m2. Previous studies suggested that, the cyclic pattern of GnRH release is lost in patients with CKD resulting in impairment of gonadotropins secretion from the anterior pituitary gland. Multiple hormonal factors had been proposed to be responsible for the pubertal delay in patients with CKD, the most prominent of which is the increasing levels of prolactin, LH and GnRH (4). Prolactin normally inhibits the release of GnRH from hypothalamus thus inhibiting the initiation of puberty and it was found to increase in patients with CKD secondary to increased production, slightly decreased clearance and decreased responsiveness to the hypothalamic inhibition of prolactin secretion.

Furthermore, recent studies reported that the Kisspeptin protein play an important role in the regulation and control of normal puberty, As it was found that the Kisspeptin neurons (the rostral periventricular region of the third ventricle (RP3V) and arcuate nucleus (ARC), are found in close association with the GnRH releasing neurons in the hypothalamus suggesting that these neurons might play a crucial role in activating and restoring the pulsatile release of GnRH, It was also found that inactivating mutations of the gene encoding for kisspeptin were associated with hypogonadotropic hypogonadism.

Detailed Description

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Conditions

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Evaluation of Some Puberty-related Hormones Among Children and Adolescents With Chronic Kidney Diseases

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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children and adolescents with chronic kidney diseases

The serum level of LH, FSH, prolactin, Testosterone (in boys), estradiol (in girls) and Kisspeptin levels will be measured for all the study participants.

serum kisspeptin levels

Intervention Type DIAGNOSTIC_TEST

Evaluation of the serum level of LH, FSH, prolactin, Testosterone (in boys), estradiol (in girls) and Kisspeptin levels

control group of patients

The serum level of LH, FSH, prolactin, Testosterone (in boys), estradiol (in girls) and Kisspeptin levels will be measured for all the study participants.

serum kisspeptin levels

Intervention Type DIAGNOSTIC_TEST

Evaluation of the serum level of LH, FSH, prolactin, Testosterone (in boys), estradiol (in girls) and Kisspeptin levels

Interventions

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serum kisspeptin levels

Evaluation of the serum level of LH, FSH, prolactin, Testosterone (in boys), estradiol (in girls) and Kisspeptin levels

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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The serum level of LH, FSH, prolactin, Testosterone (in boys), estradiol (in girls)

Eligibility Criteria

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Inclusion Criteria

In addition, Age- and sex-matched controls will be included from children and adolescents attending the general pediatric clinic at Sohag University Hospital for acute non-serious illnesses.

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Exclusion Criteria

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Minimum Eligible Age

8 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sohag University

OTHER

Sponsor Role lead

Responsible Party

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Heba Mohamed Ahmed

resident doctor at pediatrics department

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Sohag University Hospital

Sohag, , Egypt

Site Status

Countries

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Egypt

Central Contacts

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Heba A Mohamed, resident

Role: CONTACT

Phone: 01094215946

Email: [email protected]

Ahmed Mohamed H Monir, associate professor

Role: CONTACT

Phone: 01097840928

Email: [email protected]

Facility Contacts

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Magdy M Amin, professor

Role: primary

References

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Brook CG. Mechanism of puberty. Horm Res. 1999;51 Suppl 3:52-4. doi: 10.1159/000053162.

Reference Type BACKGROUND
PMID: 10592444 (View on PubMed)

Pozo J, Argente J. Delayed puberty in chronic illness. Best Pract Res Clin Endocrinol Metab. 2002 Mar;16(1):73-90. doi: 10.1053/beem.2002.0182.

Reference Type BACKGROUND
PMID: 11987900 (View on PubMed)

Levey AS, Eckardt KU, Tsukamoto Y, Levin A, Coresh J, Rossert J, De Zeeuw D, Hostetter TH, Lameire N, Eknoyan G. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2005 Jun;67(6):2089-100. doi: 10.1111/j.1523-1755.2005.00365.x.

Reference Type BACKGROUND
PMID: 15882252 (View on PubMed)

Holley JL. The hypothalamic-pituitary axis in men and women with chronic kidney disease. Adv Chronic Kidney Dis. 2004 Oct;11(4):337-41.

Reference Type BACKGROUND
PMID: 15492969 (View on PubMed)

Harter CJL, Kavanagh GS, Smith JT. The role of kisspeptin neurons in reproduction and metabolism. J Endocrinol. 2018 Sep;238(3):R173-R183. doi: 10.1530/JOE-18-0108.

Reference Type BACKGROUND
PMID: 30042117 (View on PubMed)

Other Identifiers

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Soh-Med-23-04-18MS

Identifier Type: -

Identifier Source: org_study_id