title: Differential effects of recombinant human growth hormone on glomerular filtration rate and renal plasma flow in chronic renal failure.
abstract: In normal subjects recombinant human growth hormone (rhGH) increases glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) through the action of insulin-like growth factor-I (IGF-I). We have measured clearance of inulin and para-aminohippuric acid in 18 children with chronic renal failure (CRF) during their 1st year of rhGH treatment to look at the immediate (first 3 h), short-term (1 week) and long-term (1 year) effects of treatment. On day 1 mean (range) age was 9.1 (4.9-13.9) years, GFR 19 (9-58) and ERPF 77 (34-271) ml/min per 1.73 m2. During treatment height velocity increased from 4.5 (1.7-6.5) to 9.5 (4.8-12.7) cm/year (P < 0.0001). Two children required dialysis after 0.75 years and 1 child was electively transplanted after 0.5 years. There were no other serious adverse events. GFR and ERPF were unchanged in the 3 h following rhGH. GFR remained constant on day 8, 22 (6-56) and after 1 year, 20 (9-59) ml/min per 1.73 m2. ERPF increased to 96 (33-276) ml/min per 1.73 m2 on day 8 (P = 0.005), and remained elevated, but not significantly so, at 99 (24-428) ml/min per 1.73 m2 at 1 year. Fasting IGF-I increased from 147 (46-315) ng/ml to 291 (61-673) by day 8 (P < 0.003), and to 341 (101-786) ng/ml at 1 year. There was no correlation between the change in IGF-I and renal function. Blood pressure, albumin excretion and dietary protein intake were unchanged by treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Royal Free Hospital, Hampstead, London, UK.
authors.forename: H
authors.initials: H
authors.lastname: Maxwell
authors.forename: D R
authors.initials: DR
authors.lastname: Nair
authors.forename: R N
authors.initials: RN
authors.lastname: Dalton
authors.forename: S P
authors.initials: SP
authors.lastname: Rigden
authors.forename: L
authors.initials: L
authors.lastname: Rees
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000187:drug effects; D001827:Body Height / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006130:Growth Disorders / Q000188:drug therapy / Q000209:etiology; D013006:Growth Hormone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007279:Injections, Subcutaneous; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012079:Renal Circulation / Q000187:drug effects*; D006435:Renal Dialysis; D010130:p-Aminohippuric Acid / Q000652:urine
chemical_list: D011994:Recombinant Proteins; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D003404:Creatinine; D010130:p-Aminohippuric Acid