title: Short-term growth hormone treatment and microcirculation: effects in patients with chronic kidney disease.
abstract: Endothelial dysfunction is common in patients with chronic kidney disease (CKD) and contributes significantly to the high long-term cardiovascular morbidity and mortality. The short-term cardiovascular effects of recombinant human growth hormone (rhGH) in CKD patients (stages III-V) and healthy controls (n=15 each) were explored in a single-center, non-randomized pilot study. Subjects were investigated before, after a 7 day treatment with rhGH, and after a 7 day wash-out period. Microcirculation was assessed by nailfold capillaroscopy and leg strain gauge plethysmography. Echocardiography was performed and serum concentrations of IGF-I and IGF-binding protein-3 (IGFBP-3) were determined. Before the start of rhGH therapy, mean post-ischemic maximum flow velocity of erythrocytes (V(RBC)) and leg blood flow (LBF) in CKD patients were significantly reduced to 68% and 75% of that seen in controls, whereas V(RBC) and LBF under resting conditions were comparable. Treatment with rhGH significantly increased V(RBC) and LBF under resting conditions. Whereas maximum post-ischemic V(RBC) was improved by rhGH in patients and controls, maximum post-ischemic LBF increased in controls only. This was paralleled by a non-significant reduction of total vascular resistance, and increased heart rate and cardiac index. In conclusion, CKD patients respond to short-term rhGH treatment with significantly improved capillary blood flow, whereas only minor effects on total peripheral resistance and cardiac output were noted.
authors.affiliation: Department of Pediatrics, University Children's Hospital, Rembrandtstrasse 16/17, 18057 Rostock, Germany.
authors.forename: Richard
authors.initials: R
authors.lastname: Nissel
authors.forename: Dagmar-Christiane
authors.initials: DC
authors.lastname: Fischer
authors.forename: Andreas
authors.initials: A
authors.lastname: Puhlmann
authors.forename: Birgit
authors.initials: B
authors.lastname: Holdt-Lehmann
authors.forename: Andrea
authors.initials: A
authors.lastname: Mitzner
authors.forename: Michael
authors.initials: M
authors.lastname: Petzsch
authors.forename: Thomas
authors.initials: T
authors.lastname: Körber
authors.forename: Michael
authors.initials: M
authors.lastname: Tiess
authors.forename: Reinhard
authors.initials: R
authors.lastname: Schmidt
authors.forename: Dieter
authors.initials: D
authors.lastname: Haffner
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000097:blood*; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000097:blood / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D008833:Microcirculation / Q000187:drug effects*; D018715:Microscopy, Video; D008875:Middle Aged; D010865:Pilot Projects; D010991:Plethysmography; D011994:Recombinant Proteins / Q000627:therapeutic use; D012039:Regional Blood Flow; D016896:Treatment Outcome
chemical_list: D018972:Insulin-Like Growth Factor Binding Protein 3; D011994:Recombinant Proteins; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I