Nutritional intake, somatomedin activity and linear growth in children undergoing hemodialysis

Reduced somatomedin activity was uniformly present pre-dialysis in 7 children with end-stage renal disease. Somatomedin activity improved in 6 of the 7 patients following a single 5 hr hemodialysis. Percent normal growth correlated with post-dialysis somatomedin activity in 6 of the 7 children. No correlation was present between percent normal growth and calorie or protein intake. Reduced somatomedin activity in children with end-stage renal disease appears to be due to a circulating uremic inhibitor(s). Somatomedin activity may be a useful in vitro test for adequacy of dialysis in children. Further efforts are necessary to identify the inhibitor(s) of somatomedin activity in uremia.