Endocrine And Menstrual Problem In Adolescent Girls With Chronic Kidney Disease

Abstract

Background: Chronic kidney disease (CKD) during adolescence disrupts multiple endocrine pathways and interferes with normal pubertal development and menstrual function. Objective: To determine the frequency and pattern of endocrine and menstrual abnormalities in adolescent girls with chronic kidney disease and to assess the association between CKD severity and hormonal or menstrual disturbances. Methods: This cross-sectional descriptive study was conducted at Department of Endocrinology and Diabetes, Services Hospital Lahore, from January 2024 to July 2024, included 145 adolescent girls aged 10–19 years with confirmed CKD. Clinical evaluation included Tanner staging, growth assessment, and menstrual history. Laboratory investigations included thyroid profile, prolactin, gonadotropins, estradiol, vitamin D, calcium, phosphate, and parathyroid hormone levels. Results: Endocrine abnormalities were highly prevalent, with delayed puberty observed in 38.6%, growth failure in 22.1%, thyroid dysfunction in 19.3%, hyperprolactinemia in 27.6%, vitamin D deficiency in 71.0%, and secondary hyperparathyroidism in 49.0% of participants. Menstrual disturbances among post-menarchal girls (n = 118) included oligomenorrhea (34.7%), amenorrhea (22.0%), irregular cycles (28.0%), and anovulatory bleeding (10.2%), while only 25.4% reported normal cycles. Advancing CKD stage showed a significant association with delayed puberty (p = 0.001), hyperprolactinemia (p = 0.010), secondary hyperparathyroidism (p < 0.001), and amenorrhea (p = 0.007). Conclusion: Adolescent girls with chronic kidney disease experienced a high frequency of endocrine and menstrual abnormalities, with severity increasing alongside CKD progression.