title: Peritoneal loss of growth hormone in children on automated peritoneal dialysis.
abstract: OBJECTIVE
  To provide quantitative data regarding the daily dialytic loss of growth hormone (GH) in children on peritoneal dialysis (PD).
  
  
  METHODS
  Prospective study involving 24-hour dialysate collections on 3 consecutive days in patients with and without recombinant human GH (rhGH) treatment.
  
  
  METHODS
  Single-center outpatient PD program.
  
  
  METHODS
  Twenty-six children undergoing automated PD (APD): 6 with and 20 without daily rhGH.
  
  
  METHODS
  Daily peritoneal losses of GH, alpha1-, beta2-microglobulin, transferrin, and albumin.
  
  
  RESULTS
  The mean (+/-SEM) daily dialytic GH loss was 2.18+/-0.62 microg/1.73 m2 per day in rhGH-treated patients and 0.42+/-0.28 microg/1.73 m2 per day in untreated patients, (p < 0.05). The intraindividual coefficient of variation of daily GH loss was 65%. The peritoneal loss of GH was positively correlated with that of beta2-microglobulin (r = 0.77, p < 0.001) and alpha1-microglobulin (r = 0.51, p < 0.01). The variability in beta2-microglobulin and alpha1-microglobulin elimination, together with the use of rhGH, explained 66% of the total variability of daily GH excretion. In patients without rhGH therapy, the daily peritoneal GH loss was approximately 0.05% of the estimated daily endogenous production rate based on previous estimates in children with end-stage renal failure. In patients on rhGH therapy, less than 0.1% of the injected rhGH dose was eliminated by dialysis.
  
  
  CONCLUSIONS
  Peritoneal losses of GH in children on APD account only for a minute fraction of endogenous metabolic clearance, and do not explain the variability of the rhGH treatment response. The assessment of dialytic GH elimination may be used to estimate time-integrated mean plasma GH concentrations, and to monitor rhGH treatment compliance.
authors.affiliation: Pediatric Nephrology Division, University Children's Hospital, Heidelberg, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Haffner
authors.forename: C
authors.initials: C
authors.lastname: Hofstetter
authors.forename: O
authors.initials: O
authors.lastname: Mehls
authors.forename: F
authors.initials: F
authors.lastname: Schaefer
mesh_terms: D000418:Albumins / Q000032:analysis; D000510:Alpha-Globulins / Q000032:analysis; D002648:Child; D015314:Dialysis Solutions / Q000737:chemistry*; D005260:Female; D013006:Growth Hormone / Q000032:analysis*; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010530:Peritoneal Dialysis; D011446:Prospective Studies; D014168:Transferrin / Q000032:analysis; D001613:beta 2-Microglobulin / Q000032:analysis
chemical_list: D000418:Albumins; D000510:Alpha-Globulins; D015314:Dialysis Solutions; D014168:Transferrin; C016001:alpha-1-microglobulin; D001613:beta 2-Microglobulin; D019382:Human Growth Hormone; D013006:Growth Hormone