Bone density and body composition in chronic renal failure: effects of growth hormone treatment.
Metabolic bone disease and growth retardation are common complications of chronic renal failure (CRF). We evaluated bone mineral density (BMD), bone metabolism, body composition and growth in children with CRF, and the effect of growth hormone treatment (GHRx) on these variables. Thirty-three prepubertal patients with CRF were enrolled including 18 children with growth retardation, who were treated with growth hormone for 2 years. Every 6 months, BMD of lumbar spine and total body, and body composition were measured by dual-energy X-ray absorptiometry. Biochemical parameters of bone turnover were assessed. Mean BMD of children with CRF did not differ from normal. During GHRx, BMD and bone mineral apparent density of lumbar spine and height SDS increased, whereas BMD of total body did not change. Lean body mass increased in the GH group. Alkaline phosphatase increased significantly in the GH group only. The other biochemical parameters of bone turnover increased in both groups, none of them correlated with the changes in BMD. No serious adverse effects of GHRx were reported. In conclusion, BMD of children with CRF did not differ from healthy children. Adequate treatment with alpha-calcidiol or the short duration of renal failure may have attributed to the absence of osteopenia in our patients. BMD of the axial skeleton and growth improved with GHRx.
van der Sluis
I M
IM
Department of Pediatrics, Division of Endocrinology and Nephrology, Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands. vandesluis@alkg.azr.nl
Boot
A M
AM
Nauta
J
J
Hop
W C
WC
de Jong
M C
MC
Lilien
M R
MR
Groothoff
J W
JW
van Wijk
A E
AE
Pols
H A
HA
Hokken-Koelega
A C
AC
de Muinck Keizer-Schrama
S M
SM
D000365:Age Determination by Skeleton; D015415:Biomarkers; D001823:Body Composition / Q000187:drug effects*; D001827:Body Height / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects*; D001842:Bone and Bones / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy / Q000209:etiology; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology*; D008055:Lipids / Q000097:blood; D008297:Male
D015415:Biomarkers; D008055:Lipids; D019382:Human Growth Hormone