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Urinary albumin excretion in short children treated with recombinant human growth hormone
H Sasaki1, N Takeda, I Kawamura
1Department of Pediatrics, Kurashiki Central Hospital, Japan.
Insights
Children treated with growth hormone (GH) therapy showed increased urinary albumin excretion, suggesting potential kidney changes. Further research is needed to understand these effects of GH treatment on renal function.
Area of Science:
- Pediatric Endocrinology
- Nephrology
- Biochemistry
Background:
- Growth hormone (GH) deficiency affects childhood growth.
- GH therapy is a standard treatment for short stature.
- Potential renal effects of GH therapy require investigation.
Purpose of the Study:
- To assess urinary markers of kidney function in children with GH deficiency undergoing treatment.
- To investigate the relationship between GH therapy, insulin-like growth factor I (IGF-I), and renal parameters.
Main Methods:
- Measured urinary albumin, beta 2-microglobulin (BMG), and beta-D-N-acetyl glucosaminidase (NAG) excretion.
- Compared excretion rates in 30 children on GH therapy with 30 healthy controls.
- Analyzed correlations between urinary albumin and GH treatment duration/circulatory IGF-I levels.
Main Results:
- Children on GH therapy exhibited significantly higher urinary albumin excretion rates than controls.
- BMG and NAG excretion levels were normal in both groups.
- Urinary albumin excretion correlated with circulatory IGF-I and increased after initiating GH treatment.
Conclusions:
- GH therapy may lead to functional glomerular alterations in children.
- Increased urinary albumin excretion is a potential indicator of early renal changes during GH treatment.
- Monitoring renal function during GH therapy is advisable.
Abstract:
The urinary levels of albumin, beta 2-microglobulin (BMG) and beta-D-N-acetyl glucosaminidase (NAG) were studied in 30 children with short stature due to partial or complete growth hormone (GH) deficiency under treatment. All 30 children had a normal urinalysis and no clinical evidence of renal disease. They were treated with recombinant GH in a dose of 0.5 IU/kg/week given subcutaneously. The mean albumin excretion rate (9.13 +/- 8.33 micrograms/min/1.73 m2) of these children was significantly higher than that (4.2 +/- 2.27 micrograms/min/1.73 m2) of 30 age-, sex- and pubertal status-matched normal children (p < 0.01). BMG and NAG excretion was normal in both groups. There was no correlation between the urinary albumin excretion rate and the duration of GH treatment. Among the GH-treated children, the urinary albumin excretion rate was correlated significantly with circulatory insulin-like growth factor I (IGF-I) (r = 0.65, p < 0.01). In 7 other children analyzed before and three months after start of GH treatment, the mean urinary albumin excretion rate increased significantly from 4.71 +/- 3.95 micrograms/min/1.73 m2 to 8.29 +/- 2.70 micrograms/min/1.73 m2 (p < 0.03). These results suggest the possibility of functional glomerular alterations during GH therapy.