rhGH Therapy in Chronic Kidney Diseases
Journal of Pediatric Nephrology,
Vol. 2 No. 4 (2014),
26 October 2014
,
Page 134-136
https://doi.org/10.22037/jpn.v2i4.7175
Abstract
In children with chronic kidney disease (CKD), growth retardation is not a rare problem. Factors such as malnutrition, anemia, metabolic acidosis, inadequate dialysis and growth hormone resistance may cause growth failure in these children. Growth stimulation in these children can be done by supraphysiologic doses of recombinant human GH (rhGH). It stimulates growth in prepubertal CKD children, in end-stage renal disease, and after kidney transplantation. Its underlying mechanism may be the reversal of hypercatabolic state of uremia or increases in the circulating level of insulin-like growth factor (IGF). We recommend starting the treatment when the patient height falls below the third percentile and spontaneous catch-up growth does not happen despite stabilization of other contributing factors. It is better to start rhGH therapy at a young age because there is a better response in preterminal CKD than those on dialysis. We use rhGH in CKD children at a dose of 0.045 to 0.05 mg/kg/day subcutaneously every evening and a height taller than the third percentile of the general population is our minimal goal.
Keywords: Chronic Kidney Diseases; PEG-rhGH; Growth Disorders;Body Height.
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References
Gelander L KJ, Albertsson-Wikland K. Seasonality in lower leg length velocity in prepubertal children. Acta Paediatr 1994;83:1249.
Centers for Disease Control and Prevention NCfHS, CDC Growth Charts. Available at: http://www.cdc.gov/growthcharts/clinical_charts.htm.:Accessed 28 Sep 2014.
Tanner JM DS. Clinical longitudinal standards for height and height velocity for North American children. J Pediatr 1985;107:317.
Betts PR MG. Growth pattern and dietary intake of children with chronic renal insufficiency. Br Med 1974;2:189-93.
André JL BR, Guillemin F, et al. Final height in children with chronic renal failure who have not received growth hormone. Pediatr Nephrol 2003;18:685.
Mahan JD WB. Consensus Committee. Assessment and treatment of short stature in pediatric patients with chronic kidney disease: a consensus statement. Pediatr Nephrol 2006;21:917.
Furth SL HW, Yang C, Neu AM, Fivosh BA, Powe NR. Growth failure, risk of hospitalization and death for children with end-stage renal disease. Pediatr Nephrol 2002(17):450-5.
Rosenkranz J RKE, Oh J, Turzer M, Mehls O, Schaefer F. Psychosocial rehabilitation and satisfaction with life in adults with childhood-onset of end-stage renal disease. Pediatr Nephrol 2005;20:1288-94.
Tönshoff B MO. Growth retardation in children with chronic renal insufficiency: Current aspects of pathophysiology and treatment. J Nephrol 1995;8:133.
Tom A, Mc Cauley L, Bell L, et al. Growth during maintenance hemodialysis: impact of enhanced nutrition and clearance. J Pediatr 1999;134:464.
Kari JA, Gonzalez C, Ledermann SE, et al. Outcome and growth of infants with severe chronic renal failure. Kidney Int 2000;57:1681.
Boirie Y, Broyer M, Gagnadoux MF, et al. Alterations of protein metabolism by metabolic acidosis in children with chronic renal failure. Kidney Int 2000;58:236.
Tönshoff B, Kiepe D, Ciarmatori S., et al. Growth hormone/insulin-like growth factor system in children with chronic renal failur. Pediatr Nephrol 2005;20:279.
Fine RN. Etiology and treatment of growth retardation in children with chronic kidney disease and end-stage renal disease: a historical perspective. Pediatr Nephrol 2010;25:725-32.
Mencarelli F KD, Leozappa G, Stringini G, Cappa M, Emma F. Growth hormone treatment started in the first year of life with chronic renal failure. Pediatr Nephrol 2009;24:1039-46.
Kaufman D. Growth hormone and renal osteodystrophy: a case report. Pediatr Nephrol 1998;12:157-9.
Blethen SL RA. Slipped capital femoral epiphysis in children treated with growth hormone. A summary of the National Cooperative Growth Study Experience. Horm Res. 1996 46:113-6.
Reeves GD DD. Growth hormone treatment and pseudotumor cerebri: coincidence or close relationship? J Pediatr Endocrinol Metab 2002;15:723-30.
Radetti G CR, Paganini C, Gentili L, Pitscheider W. Medium-term cardiovascular effects of high-dose growth hormone treatment in growth hormone-deficient children. Horm Res 1999;52:247-52.
Fine RN KE, Brown D, Perlman AJ, the Genentech Cooperative Study Group. Growth after recombinant human growth hormone treatment in children with chronic renal failure: Report of a multicenter randomized double-blind placebocontrolled study. J Pediatr 1994;124:374-82.
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