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Intraperitoneal administration of recombinant human growth hormone in children with end-stage renal disease
D S Gipson1, A T Kausz, J E Striegel
1Division of Nephrology, Children's Hospital and Regional Medical Center, 4800 Sand Point Way NE, Seattle, WA 98105, USA.
Insights
Intraperitoneal administration of recombinant human growth hormone (GH) effectively treats growth failure in children with chronic renal failure on peritoneal dialysis. This method improved growth velocity without increasing peritonitis risk, offering a viable alternative to injections.
Area of Science:
- Pediatric Nephrology
- Endocrinology
- Pharmacology
Background:
- Chronic renal failure in children often leads to growth failure.
- Recombinant human growth hormone (GH) is effective via subcutaneous injection.
- Alternative administration routes are needed for patients on peritoneal dialysis.
Purpose of the Study:
- To evaluate the effectiveness and tolerability of intraperitoneal (i.p.) administration of GH.
- To assess growth outcomes in prepubertal peritoneal dialysis patients receiving i.p. GH therapy.
Main Methods:
- Nine prepubertal peritoneal dialysis patients were enrolled in the study.
- Eight subjects completed 24 months of i.p. GH therapy.
- Growth velocity and height standard deviation scores (SDS) were compared to baseline.
Main Results:
- Mean height velocity increased significantly in the first year of i.p. GH therapy (4.6 cm/yr to 8.5 cm/yr, P < 0.05).
- Height SDS showed a trend towards improvement over 2 years.
- Peritonitis infection rates did not increase compared to center rates.
Conclusions:
- Intraperitoneal administration of GH is an effective and tolerable option for treating short stature in children on maintenance peritoneal dialysis.
- This route offers a practical alternative to subcutaneous injections for this patient population.
Abstract:
Recombinant human growth hormone (GH) therapy has been shown to be effective in the treatment of growth failure related to growth hormone resistance among children with chronic renal failure. The traditional route of administration is subcutaneous injection. This study was designed to evaluate the effectiveness and tolerability of intraperitoneal (i.p.) administration of GH in prepubertal peritoneal dialysis patients. Nine subjects were enrolled. Eight completed 24 months of therapy with GH. Baseline height standard deviation scores (SDS) and growth velocity for the prior year were used for comparison. Peak serum GH was achieved 4 h after administration and serum half-life was 4.6 h. Mean height SDS was -3.1 at baseline, -2.5 at 1 year, and -2.3 at 2 years (NS) of GH therapy. Mean height velocity increased from a baseline of 4.6 cm/yr to 8.5 cm/yr in year 1 (P < 0.05) and 6.1 cm/yr in year 2 (NS) of i.p. GH therapy. Peritonitis infection rates were not increased from overall center rates. This research suggests that the intraperitoneal route of administration of GH can be utilized in the treatment of short stature among children requiring maintenance peritoneal dialysis therapy.