Related Experiment Videos
Accelerated growth and improved nutritional status after recombinant human growth hormone (rhGH) therapy in uremic
N Ivanovski1, Z Antova, K Cakalaroski
1Department of Nephrology, University Clinical Centre, Skopje, Republic of Macedonia.
Insights
Recombinant human growth hormone (rhGH) therapy significantly improved height velocity and nutritional status in children with growth retardation on maintenance hemodialysis. rhGH is recommended for uremic children experiencing growth failure or malnutrition.
Area of Science:
- Pediatric Nephrology
- Endocrinology
- Growth Hormone Therapy
Background:
- Children on maintenance hemodialysis often suffer from growth retardation.
- Nutritional status is a critical factor in the overall health and development of these patients.
Purpose of the Study:
- To evaluate the efficacy of recombinant human growth hormone (rhGH) therapy in improving growth and nutritional status in children undergoing maintenance hemodialysis.
- To assess the impact of rhGH on height velocity, body composition, and serum albumin levels.
Main Methods:
- A study involving 6 children (4 boys, 2 girls) on maintenance hemodialysis, aged 11-17 years.
- rhGH administered at 4 IU/m2/day subcutaneously, with height velocity measured before and 6, 12 months after therapy.
- Nutritional status assessed via anthropometric measurements (triceps skinfold thickness, midarm muscle circumference, lean body mass) and serum albumin concentration.
Main Results:
- Mean height velocity significantly increased from 1.67 cm/year pre-therapy to 6.70 cm/year at 12 months (p < 0.001).
- Significant improvements observed in body weight, body surface area, lean body mass, midarm muscle circumference, and serum albumin concentration (p < 0.001 for most parameters).
- Triceps skinfold thickness showed a non-significant decrease, while other nutritional markers improved, confirming rhGH's beneficial effects.
Conclusions:
- rhGH therapy is effective in enhancing linear growth in children with growth retardation on maintenance hemodialysis.
- rhGH treatment positively impacts nutritional status, including lean body mass and protein levels, in this patient population.
- The study recommends rhGH therapy for uremic children with growth retardation and malnutrition.
Abstract:
The effect of recombinant human growth hormone (Norditropin, Novonordisk) was studied in 6 children (4 boys and 2 girls) on maintenance hemodialysis, age 13.8 (range 11-17) years. The recombinant human growth hormone (rhGH) was given in a dose of 4 IU/m2/day s.c. Height velocity was followed 6 months before therapy (washout period) and 6 and 12 months later. Growth was estimated by use of Holtain stadiometer in the same conditions and by the same investigator. Nutritional status was assessed by anthropometric measurements including triceps skinfold thickness (TST), midarm muscle circumference (MAMC), and lean body mass (LBM), as well as serum albumin concentration. The mean height velocity increased from 1.67 +/- 0.98, before therapy to 3.33 +/- 1.25 and 6.70 +/- 0.9 cm 6 and 12 months after therapy, respectively (p < 0.001). Body weight also increased during the treatment period from 29.45 +/- 5.24 to 30.96 +/- 6.4 and 31.68 +/- 6.42 kg (p < 0.02) and so did body surface area from 1.01 +/- 0.12 to 1.07 +/- 0.13 and 1.15 +/- 0.1 m2 (p < 0.001). LBM increased from 26.8 +/- 5.4 to 29.85 +/- 6.42 and 31.1 +/- 7.01 kg 6 and 12 months after therapy (p < 0.001). There was a decrease in TST from 7.35 +/- 1.8 to 6.8 +/- 2.18 and 6.8 +/- 2.4 mm (p < 0.3, NS), and an increase in MAMC from 15.15 +/- 2.42 to 16.1 +/- 2.4 and 17.63 +/- 2.6 cm 6 and 12 months after therapy (p < 0.001). Serum albumin concentration increased from 33.5 +/- 1.22 to 36.0 +/- 2.4 and 38.66 +/- 1.03 g/L (p < 0.001). Nutrition parameters confirmed the beneficial effect of rhGH therapy. The authors recommend rhGH therapy in uremic children with growth retardation as well as in any case of malnutrition in these patients.