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Effects of growth hormone on growth factors after renal transplantation

J P Clot1, H Crosnier, G Guest

  • 1INSERM U530, Hôpital des Enfants Malades, 149 rue de Sèvres, 75743 Paris Cedex 15, France.

Pediatric Nephrology (Berlin, Germany)
|June 19, 2001
PubMed

Insights

Growth hormone (GH) therapy improved growth in renal transplanted children, increasing insulin-like growth factor-1 (IGF-1) and IGF binding protein-3 (IGFBP-3). However, corticosteroid use may cause IGF-1 insensitivity, limiting optimal growth response.

Area of Science:

  • Pediatric Endocrinology
  • Nephrology
  • Growth Hormone Therapy

Background:

  • Growth retardation is common in children post-renal transplantation (RTx).
  • Growth hormone (GH) treatment can potentially improve growth in these patients.
  • Understanding the IGF-1/IGFBP axis is crucial for assessing treatment efficacy.

Purpose of the Study:

  • To evaluate the IGF-1 and IGFBP profile in growth-retarded children after renal transplantation during GH therapy.
  • To assess the impact of GH treatment on growth parameters and the IGF system.
  • To investigate potential factors contributing to suboptimal growth response.

Main Methods:

  • Retrospective analysis of ten prepubertal children with RTx and growth retardation.
  • Administration of recombinant human GH (4 IU/m2/day) for one year.
  • Measurement of plasma GH, total and free IGF-1, IGFBP-2, and IGFBP-3 using radioimmunoassay (RIA), SDS-PAGE, ligand, and immunoblot analyses.

Main Results:

  • Significant increase in growth velocity (SD score for bone age) after GH therapy (P < 0.01).
  • Doubled plasma levels of total and free IGF-1 (P < 0.01).
  • Increased IGFBP-3 concentrations by approximately 40% (P < 0.01), with no change in IGFBP-2.

Conclusions:

  • GH therapy effectively increases IGF-1 and IGFBP-3 levels in children with RTx.
  • The observed growth response suggests potential IGF-1 insensitivity, possibly linked to corticosteroid use.
  • Further research is needed to optimize GH therapy in this patient population.

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