[The epiphyseal plate in hemodialysis, peritoneal dialysis and following kidney transplantation].

We evaluated growth, maturity of the skeleton and formation of skeletal deformities and epiphysiolysis of the femoral head in 22 children with end-stage renal failure undergoing haemodialysis, CAPD (continuous ambulatory peritoneal dialysis) and after kidney transplantation. We found growth retardation and disturbances of skeletal maturity in 64% of the children and skeletal deformities in 45%. Children undergoing haemodialysis showed a higher rate of retardation in growth and skeletal maturity than those undergoing CAPD and kidney transplantation. A high level of cortisone and frequent rejections after renal transplantation also lead to poorer growth and skeletal maturity. Children suffering from congenital renal dysfunction showed a higher rate of skeletal deformities. During haemodialysis the level of PTH (parathyroid hormone) was significantly higher than during CAPD and after renal transplantation. Epiphysiolysis capitis femoris lenta was found in 3 children, two of which occurred on both sides. These children had a significantly higher average level of PTH than the other 19.