Hyperprolactinemia as a prognostic factor for menstrual disorders in female adolescents with advanced chronic kidney disease

Juana Serret-Montaya,Jessie N. Zurita-Cruz,Miguel A. Villasís-Keever, Alejandra Aguilar-Kitsu,Claudia del Carmen Zepeda-Martinez, Irving Cruz-Anleu, Beatriz C. Hernández-Hernández,Sara R. Alonso-Flores,Leticia Manuel-Apolinar,Leticia Damasio-Santana,Abigail Hernandez-Cabezza, José C. Romo-Vázquez

Pediatric Nephrology(2020)

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摘要
Background In adolescents with chronic kidney disease (CKD), menstrual disorders (MD) are common, which can make the management of CKD difficult and can sometimes delay renal transplantation. This study aimed to identify the usefulness of hormonal measurements in adolescents with CKD and their relationships with MD during a 1-year follow-up. Methods A prospective cohort study was designed. Adolescents with CKD stages IV and V were included. Through clinical files and via interview, the ages at puberty onset, menarche and the date of last menstruation were identified. A 1-year follow-up was conducted over a menstrual cycle calendar. At the beginning of follow-up, routine hormonal profiles (thyroid profiles, prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol) were assessed. We compared the hormonal profiles of the patients with and without MD (wMD vs. woMD). Comparisons between groups were made by Wilcoxon and Fisher’s tests. Logistic regression analysis was used. Results Fifty-seven patients, including 30 patients classified as wMD, were analyzed. The median age was 15 years, and the median time of CKD evolution was 18 months. There were no differences in general and biochemical characteristics between patients wMD and woMD. In terms of hormonal measurements, the levels of thyroid-stimulating hormone (TSH) and prolactin were higher in the wMD patients. A prolactin level ≥ 36.8 ng/ml was a risk factor for presenting with MD (RR 34.4, p = 0.002). Conclusions Hyperprolactinemia is correlated with MD in adolescents with CKD.
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关键词
Adolescent,Chronic kidney disease,Menstrual disorder,Hyperprolactinemia
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