Related Experiment Videos
Growth hormone treatment in children with chronic renal failure: a meta-analysis of randomized controlled trials
D Vimalachandra1, J C Craig, C T Cowell
1Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia.
Objective:
To evaluate the benefits and side effects of recombinant human growth hormone (hGH) treatment in children with chronic renal failure.
Methods:
Two reviewers independently assessed relevant randomized controlled trials for methodologic quality, extracted data, and estimated summary treatment effects by use of a random effects model.
Results:
Ten randomized controlled trials involving 481 children were identified. Treatment with hGH (28 IU/m(2)/wk) resulted in a significant increase in height standard deviation score at 1 year (4 trials, weighted mean difference [WMD] = 0.77, 95% CI = 0.51 to 1.04), and a significant increase in height velocity at 6 months (2 trials, WMD = 5.7 cm/y, 95% CI 4.4 to 7.0) and 1 year (2 trials, WMD = 4.1 cm/y, 95% CI 2.6 to 5.6), but there was no further increase in height indexes during the second year of administration. Compared with the 14 IU/m(2)/wk group, there was an increase of 1.4 cm/y (0.6 to 2.2) in height velocity in the group treated with 28 IU/m(2)/wk. The frequency of reported side effects of hGH were similar to that of the control group.
Conclusion:
On average, 1 year of treatment with 28 IU/m(2)/wk hGH in children with chronic renal failure results in an increase of 4 cm/y in height velocity above that of untreated control subjects, but there was no demonstrable benefit for longer courses or higher doses of treatment.
Related Concept Videos
Chronic Kidney Disease III: Interprofessional Care
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
Heart Failure VI: Adjunct Therapies
Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate
Pharmacokinetics in Pediatric Patients: Drug Excretion
Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...