Growth-stimulating effects of recombinant human growth hormone in children with end-stage renal disease.
Because patients with uremia have evidence for growth hormone resistance, we investigated whether this resistance can be overcome by administration of recombinant human growth hormone in supraphysiologic doses in children with severe uremia. Nine stunted children with end-stage renal disease (median age 5.8 years, median bone age 2.7 years) were treated with recombinant human growth hormone, 4 IU/m2/day subcutaneously, for a period of 1 year. Median height velocity was increased from 4.4 cm/yr before therapy to 8.0 cm/yr during treatment. Negative values for height velocity standard deviation scores for chronologic age were improved from a median of -2.6 to +1.5 without advancing bone age more than chronologic age. The growth hormone-insulin-like growth factor I resistance may be explained in part by the increased serum concentration of the high molecular weight insulin-like growth factor binding protein despite normal insulin-like growth factor I serum concentration. Treatment with recombinant human growth hormone improved the ratio between the serum concentrations of insulin-like growth factor I and its binding protein, and normalized the somatomedin bioactivity in the growth cartilage bioassay.
Tönshoff
B
B
Department of Pediatrics, University Children's Hospital of Heidelberg, Federal Republic of Germany.
Mehis
O
O
Heinrich
U
U
Blum
W F
WF
Ranke
M B
MB
Schauer
A
A
D000365:Age Determination by Skeleton; D001827:Body Height; D001830:Body Surface Area; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy* / Q000209:etiology; D013006:Growth Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D007335:Insulin-Like Growth Factor II / Q000032:analysis; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications*; D008297:Male; D011994:Recombinant Proteins; D012885:Skinfold Thickness; D013002:Somatomedins / Q000032:analysis; D014511:Uremia / Q000097:blood / Q000150:complications
D011994:Recombinant Proteins; D013002:Somatomedins; D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II; D013006:Growth Hormone