title: Evaluation of clinical and laboratory parameters during 2 years of growth hormone treatment in prepubertal children with chronic renal failure.
abstract: Twelve prepubertal children with chronic renal failure (CRF) were treated with human growth hormone (GH) (1.2 IU/kg/week) for 2 years. High doses of GH clearly increased growth velocity, from 3.8 +/- 1.3 to 9.6 +/- 1.5 (P = 0.0001) and 6.9 +/0 0.8 cm/year (P = 0.0001) after the 1st and 2nd year of treatment, respectively, leading to a mean height gain of 1.4 SD. During the 1st year of treatment the height increment, expressed in SDS, correlated negatively with chronological age (P = 0.003). Basal insulin-like growth factor 1 (IGF 1) levels were normal or elevated (7/12 patients) and correlated positively with the overnight integrated GH concentration (r = 0.68, P < 0.001). Basal insulin-like growth factor binding protein 3 (IGF-BP3) levels were elevated in 8/12 patients. GH induced a significant increase in IGF 1 and IGF-BP3 levels; IGF 1 peaked after 6 months (when growth velocity was optimal) and IGF-BP3 peaked after 12 months. The mean glomerula filtration rate, measured by inulin clearance and corrected for body surface area, fell after the 1st year of treatment, and significantly so at the end of the 2nd year (P = 0.02).
  
  
  CONCLUSIONS
  Early initiation of GH therapy during CRF may prevent severe growth retardation and allow these children to attain normal height before dialysis and transplantation.
authors.affiliation: Service d'Endocrinologie Pédiatrique, Hôpital Robert DEBRE, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Simon
authors.forename: M
authors.initials: M
authors.lastname: Neol
authors.forename: P
authors.initials: P
authors.lastname: Brun
authors.forename: D
authors.initials: D
authors.lastname: Porquet
authors.forename: P
authors.initials: P
authors.lastname: Rocchicioli
authors.forename: C
authors.initials: C
authors.lastname: Loirat
authors.forename: P
authors.initials: P
authors.lastname: Czernichow
mesh_terms: D019540:Area Under Curve; D001827:Body Height / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000378:metabolism; D005260:Female; D005919:Glomerular Filtration Rate; D013006:Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D018969:Insulin-Like Growth Factor Binding Proteins / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007444:Inulin / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000188:drug therapy*; D008297:Male
chemical_list: D018969:Insulin-Like Growth Factor Binding Proteins; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D007444:Inulin; D003404:Creatinine