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Absorption of recombinant human growth hormone (rhGH) following intraperitoneal instillation
R N Fine1, S E Fine, B M Sherman
1Department of Pediatrics, UCLA Center for the Health Sciences.
Insights
Recombinant human growth hormone (rhGH) administered intraperitoneally (i.p.) showed immediate absorption in children on continuous cycling peritoneal dialysis (CCPD). Daily i.p. rhGH may improve growth velocity in these pediatric patients.
Area of Science:
- Pediatric Endocrinology
- Nephrology
- Pharmacokinetics
Background:
- Children undergoing continuous cycling peritoneal dialysis (CCPD) often experience growth impairment.
- Growth hormone therapy is crucial for addressing growth deficits in pediatric patients.
- Understanding the absorption profile of growth hormone in CCPD patients is essential for effective treatment.
Purpose of the Study:
- To evaluate the absorption and pharmacokinetic profile of intraperitoneally administered recombinant human growth hormone (rhGH) in children undergoing CCPD.
- To determine the optimal dosage and timing for i.p. rhGH administration in this patient population.
Main Methods:
- Six children undergoing CCPD received intraperitoneal (i.p.) instillations of rhGH at varying dosages (0.250, 0.125, or 0.050 mg/kg).
- Serum growth hormone (GH) levels were monitored at multiple time points post-administration (4, 8, and 24 hours).
- Absorption curves were analyzed to assess the efficacy of different rhGH dosages.
Main Results:
- rhGH demonstrated immediate absorption following i.p. administration across tested dosages.
- Peak serum GH levels were observed at 4 and 8 hours, returning to baseline by 24 hours.
- Higher rhGH dosages showed adequate absorption, while lower dosages resulted in diminished absorption.
Conclusions:
- Daily intraperitoneal administration of rhGH is feasible and shows promising absorption in children with CCPD.
- This administration route could be a viable option for clinical trials aimed at enhancing growth velocity in pediatric CCPD patients.
- Further investigation into i.p. rhGH therapy is warranted for improving growth outcomes in children with chronic kidney disease on peritoneal dialysis.
Abstract:
Recombinant human growth hormone (rhGH) was instilled intraperitoneally (i.p.) in six children undergoing continuous cycling peritoneal dialysis (CCPD). Immediate absorption was noted with either 0.250 mg/kg, 0.125 mg/kg, or 0.050 mg/kg of rhGH. Peak serum growth hormone (GH) levels occurred 4 and 8 h following i.p. administration, and the serum GH levels had returned to baseline values at 24 h. In one patient, a higher dosage demonstrated adequate absorption, whereas the lower dosage produced a flat absorption curve. These data indicate that daily i.p. administration of rhGH could be utilized in clinical trials directed toward improving the growth velocity of children undergoing CCPD.