Recombinant human growth hormone treatment, using two dose regimens in children with chronic renal failure--a report on linear growth and adverse effects.
The aim of this study was to study the efficiency and the adverse effects of 2 or 4 IU/m2/day of growth hormone (GH) in the first year and 4 IU/m2/day in the second. Of 29 growth-retarded children with chronic renal failure (CRF) (aged 3.4-15.1 years), 23 completed the first year of therapy, and 16 completed the second year. Height velocity SDS (HVSDS) increased in the first year in the low-dose group with 3.0, and 3.8 in the high-dose group. In the second year, HVSDS increased by 1.3 in the low-dose group and by 2.1 in high-dose group (p < 0.05). The IGF-I/IGFBP-3 ratio rose identically during the first year (p < 0.01). The retarded bone age did not advance inappropriately. The integrated insulin levels (AUC) increased significantly after 1 year of therapy in both groups. HbA1c, levels did not change. The number of adverse events was highest in the low-dose group, in which one patient developed overt insulin dependent diabetes mellitus. In conclusion, glucose metabolism should be monitored in children with CRF during rhGH-treatment. GH therapy in our patients resulted in a significant increase in height velocity with no inappropriate bone age progression and few serious adverse effects, all without relation to the dose of rhGH. The low start dose (2 IU/m2/ day) was of no advantage compared to the high dose.
Hertel
Niels Thomas
NT
Department of Growth and Reproduction, Righospitalet, University of Copenhagen, Denmark. thomas.hertel@dadlnet.dk
Holmberg
Christer
C
Rönnholm
Kai A R
KA
Jacobsen
Bendt Brock
BB
Olgaard
Klaus
K
Meeuwisse
Gunnar W
GW
Rix
Mariane
M
Pedersen
Fritz Bangsgaard
FB
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D001827:Body Height; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006130:Growth Disorders / Q000188:drug therapy* / Q000209:etiology; D019382:Human Growth Hormone / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D007328:Insulin / Q000097:blood; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000032:analysis; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D008297:Male
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D019382:Human Growth Hormone; D007328:Insulin; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I