Puberty in chronic renal failure

Puberty is a period of transition characterized by a sequence of profound p hysical and psychological changes leading to full sexual maturity. This pro cess is driven and orchestrated by the awakening of the gonadotropic hormon e axis. Chronic renal failure and its treatment may interfere with the onse t and progress of puberty by numerous mechanisms including endocrine, metab olic and neuropsychological abnormalities, and drug effects. On average, th e onset of puberty is delayed by 2 years in children with chronic renal fai lure, even after successful transplantation. Moreover, pubertal height gain is only 50% of that observed in healthy children. In this report, we discu ss the endocrine mechanisms underlying these alterations and highlight new therapeutical options for pubertal growth failure. (C) 1999 by the National Kidney Foundation, Inc.