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[Growth hormone therapy in prepubertal children with chronic renal insufficiency]
L Kost'álová1, Z Misíková, K Furková
1II. Detská klinika DFNsP, Bratislava.
Insights
Growth hormone (GH) therapy significantly improved height velocity in prepubertal children with chronic renal failure (CRF). This treatment offers a promising solution for growth retardation in pediatric CRF patients.
Area of Science:
- Pediatric Endocrinology
- Nephrology
- Biochemistry
Context:
- Children with chronic renal failure (CRF) often experience growth retardation.
- Standard medical care and dialysis do not effectively improve height velocity in these children.
- Endogenous growth hormone (GH) secretion is typically normal in affected children.
Purpose:
- To evaluate the efficacy of biosynthetic growth hormone (GH) therapy in improving height velocity in prepubertal children with CRF-induced growth retardation.
Summary:
- Seven prepubertal children with severe growth retardation and CRF received biosynthetic GH (1 IU/kg/week) subcutaneously for one year.
- Height velocity improved in five out of six children who completed the study.
- While GH treatment increased alkaline phosphatase and decreased calcium levels, it did not affect glucose, thyroid, or lipid concentrations. Renal function deterioration was accelerated in two patients.
Impact:
- Biosynthetic GH therapy demonstrated an impressive improvement in height velocity for growth-retarded prepubertal children with CRF.
- This highlights GH therapy as a potential therapeutic strategy for addressing growth issues in pediatric CRF.
- Further research may be needed to monitor long-term effects and manage potential side effects like accelerated renal function decline.
Background:
Growth retardation is a serious problem in children with chronic renal failure (CRF) despite normal endogenous growth hormone (GH) secretion. Intensive medical care and dialysis do not improve height velocity. The aim of the study was to evaluate the efficacy of GH therapy in children with growth retardation secondary to CRF.
Methods And Results:
Biosynthetic growth hormone was given to 7 prepubertal children (five boys and 2 girls, age with a range 3.5-14.5 years) with severe growth retardation and CRF during 1 year. The dosage of GH was 1 IU/kg/per week. GH was given daily, sc. The patients had a full examination every 3 months. Six children completed the study. Height velocity improved with GH therapy in 5 children. Renal function deterioration was accelerated in 2 children. The serum alkaline phosphatase concentration increased and the serum calcium concentration decreased during GH treatment in all children. Glucose, thyroid gland hormone concentration and lipid concentrations remained constant.
Conclusions:
The study showed clearly that treatment with biosynthetic GH gave an impressive improvement of height velocity in growth retarded prepubertal children with CRF.