SLIPPED CAPITAL FEMORAL EPIPHYSIS ASSOCIATED WITH RENAL-FAILURE OSTEODYSTROPHY

A retrospective institutional and literature review of 31 children (20 boys and 11 girls) with 58 renal failure-associated slipped capital f emoral epiphyses (RFASCFEs) was performed. The average age at diagnosi s of renal failure was 8.9 years, and for RFASCFE 11.5 years, with a l inear correlation between these two ages. All patients had secondary h yperparathyroidism at diagnosis of the RFASCFE. The median height and weight were below the 5th percentile. The RFASCFEs were stable and bil ateral in 95% of the children. Slip magnitude was mild in 53%, moderat e in 8%, and severe in 39%. Avascular necrosis was associated with ste roid immunosuppression in children with renal transplants. All childre n were treated with medical management; surgery was used in an additio nal 29 hips. If correction of secondary hyperparathyroidism is not ach ieved within 2 months, RFASCFEs are likely to progress and surgical st abilization is recommended.