| The Effect of Recombinant Human Growth Hormone on the Growth in the Children with Chronic Renal Failure |
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Sei Won Yang, Young Choi |
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Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea |
| 만성 신부전증 환자에서 3년간의 성장호르몬 투여에 따른 성장예후의 변화 |
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양세원, 최용 |
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서울대학교 의과대학 소아과학교실 |
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| Abstract |
Purpose
: We observed the effect of three year-administration of recombinant human growth
hormone(rhGH) on the growth in the children with chronic renal failure(CRF).
Methods
: Five prepubertal children(three boys and two girls) with CRF, who had been
managed by conservative methods, were given rhGH(1 U/kg/week) for three years. Growth
parameters, such as growth velocity, height standard deviation score(SDS), and predicted final
adult height, obtained by TW, BP, and RWT methods, were monitored during rhGH treatment
periods.
Results
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1) The GV increased significantly with rhGH therapy from 3.8¡¾1.2cm/year to 8.4¡¾1.3cm/year
(1st year), 7.1¡¾3.8cm/year(2nd year), and 6.3¡¾0.9cm/year(3rd year) and GV tended to decrease
over years with rhGH therapy(Fig. 1, p<0.05).
2) The height SDS increased signficantly with rhGH from -3.2¡¾1.3 to -2.6¡¾1.1(1st year), -2.2¡¾
1.2(2nd year) and -2.2¡¾1.5(3rd year) and height SDS also tended to decrease over years with
rhGH therapy(Fig. 2, p=0.05).
3) FAHs, obtained by TW and BP methods, seemed to increase at 1st and 2nd year of rhGH
therapy(p=0.05, and p<0.05, respectively), but did not show any significant increase at 3rd year
of therapy, compared to those of pretreatment. FAH, obtained by RWT method, did not show
any significant change with rhGH therapy.
4) There was no significant correlation between the GV and chronological or bone age at the
start of rhGH therapy, but there was a significant correlation between the chronological age and
the height SDS at 2nd year(p<0.05, r=-0.93) and at 3rd year (p<0.05, r=-0.97) of rhGH
therapy(Fig. 4), but there was no relationship between the height SDS and bone age.
5) There had been no noticeable side effect, especially deterioration of renal function.
Conclusion
: The long-term administration of rhGH in the children with CRF can result in the
improvement of growth parameters, such as growth velocity, height SDS, and predicted final
adult height, but these parameters seems to be weakened over years with rhGH therapy, which
could be overcome by the increase of rhGH dose. It seems to be better to start rhGH treatment
at an early stage of CRF and early chronological age to achieve better growth. |
| Key Words:
Chronic renal failure, Growth hormone treatment |
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