Growth hormone therapy in chronic renal failure induces catch-up of head circumference

Dyck, Maria Van; Proesmans, Willem

doi:10.1007/s004670100617

Cited by 6 publications

(6 citation statements)

References 25 publications

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“…Several studies detail the effects of recombinant human growth hormone (rhGH) therapy in renal conditions and most deal with the effect of rhGH therapy on children who have end-stage renal disease (ESRD) or on those who are on dialysis or who are post renal transplant [1,2,3,4,5]. This is the first report of rhGH therapy in growth-retarded children with autosomal recessive polycystic kidney disease (ARPKD) who have mild-to-moderate renal dysfunction.…”

Section: Introductionmentioning

confidence: 97%

Recombinant human growth hormone therapy in autosomal recessive polycystic kidney disease

Lilova

Kaplan

Meyers

2003

Pediatric Nephrology

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Patients with autosomal recessive polycystic kidney disease (ARPKD) may have growth retardation that is disproportionate to the degree of renal dysfunction. We treated growth-retarded ARPKD patients with recombinant growth hormone (rhGH) and document the response to therapy and effect of rhGH on the rate of progression of renal failure. The diagnosis of ARPKD and congenital hepatic fibrosis was made on the basis of clinical findings and by abdominal ultrasound examinations. Seventeen patients (6 girls/11 boys) aged 0.3-18.3 years were studied. Diagnosis was made prenatally in 6, after birth in 3, and in 8 between 0.33 and 10 years. Follow-up was 2 months to 14.3 years (median 6.9 years). Growth, growth velocity, weight, and bone age were measured before and after treatment with rhGH. Insulin-like growth factor-1 and IGF binding protein 3 were measured prior to rhGH therapy. Five children (1 girl/4 boys) with height Z-scores < or =1.2 (5/17) aged 4.5-11.9 years received rhGH therapy. Duration of rhGH therapy was 0.3-5.4 years. All responded to rhGH (Z-score before -2.8 vs. -1.26 after treatment, P=0.03). An increase in height Z-score was noted 0.5-1.5 years after starting rhGH therapy. There were no side effects from rhGH therapy. The initial Z-score in the untreated group was -0.35 and the final score was -0.64. Initial glomerular filtration rate (GFR) in the treated group was 77 versus 104 ml/min per 1.73 m(2) in the non-treated group. GFR in 3 of 6 growth-retarded patients (<5th percentile) was 38, 65, and 30 ml/min per 1.73 m(2). GFR in 2 of 11 non-growth-retarded patients was 30 and 26 ml/min per 1.73 m(2). The change from initial GFR and final GFR in treated patients was 77 versus 76 ml/min per 1.73 m(2), and non-treated patients 104 versus 89 ml/min per 1.73 m(2) ( P>0.05). Growth failure in ARPKD may be attributable to factors other than chronic renal insufficiency alone. Use of rhGH therapy in ARPKD is safe, effective, and has the potential to improve the physical and psychological well-being of these children.

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Section: Introductionmentioning

confidence: 97%

Recombinant human growth hormone therapy in autosomal recessive polycystic kidney disease

Lilova

Kaplan

Meyers

2003

Pediatric Nephrology

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“…Early research indicated rather poor developmental outcomes for children with chronic kidney disease (CKD) during infancy, with the incidence of developmental delays estimated at 60% to 85% (Bale, Siegler, & Bray, 1980;Baluarte, Gruskin, Hiner, Foley, & Grover, 1977;Bird & Semmler, 1986;Bock et al, 1989;McGraw & Haka-Ikse, 1985;Polinsky, Kaiser, Stover, Frankenfield, & Baluarte, 1987;Rotundo et al, 1982;Warady, 2002). Neurodevelopmental delays in infants and preschool children with CKD were linked to a number of neurologically based conditions including microcephaly, seizures, mental retardation, reduced growth rates, impaired hemispheric maturation, and abnormal electrophysiological findings (Bock et al, 1989;Kari, Gonzalez, Ledermann, Shaw, & Rees, 2000;McGraw & Haka-Ikse, 1985;Polinsky et al, 1987;Rotundo et al, 1982;Van Dyck & Proesmans, 2001). In addition, early malnutrition, aluminum toxicity, hypertension, and anemia were also associated with developmental delay in patients with childhood CKD (Andreoli, Bergstein, & Sherrard, 1984;Conley, 1987;Lande, Kaczorowski, Auinger, Schwartz, & Weitzman, 2003;Marsh et al, 1991;National Kidney Foundation [NKF], 2001;Sedman, Miller, Warady, Lum, & Alfrey, 1984;Sedman, Wilkening, Warady, Lum, & Alfrey, 1984;Warady, 2002;Winick, 1969).…”

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confidence: 99%

Neurodevelopmental Status and Adaptive Behaviors in Preschool Children with Chronic Kidney Disease

et al. 2008

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This study examines the early neurodevelopmental function of infants and preschool children who have chronic kidney disease (CKD). Fifteen patients with CKD are compared to a healthy control group using the Mullen Scales of Early Learning (MSEL) and the Vineland Adaptive Behavior Scale (VABS). Multivariate analysis reveals significant differences between the CKD and control groups on both MSEL (p < .01) and VABS (p < .001) composite scales, with the group with CKD obtaining lower scores on both composites. A higher proportion of children with CKD meet federal eligibility criteria for early cognitive delay, but similar proportions are found across adaptive behaviors. Disease severity is positively correlated to cognitive and adaptive functioning such that lower scores are associated with less renal function (MSEL r = .62, p < .001; VABS r = .70, p < .001). Suggestions are made in regard to special education assessment and service provision.

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“…In the early nineties, the multicenter, randomized, double-blind, placebo-controlled study of Fine et al (36), showed that rhGH therapy could significantly improve the growth of children with CKD. Clinical studies (18,23,(39)(40)(41)(42)(43) demonstrated the safety and efficacy of rhGH therapy in promoting height gain in children with CKD on dialysis or after kidney transplantation.…”

Section: Discussionmentioning

confidence: 99%

“…Chronic Kidney Disease (CKD) in pediatric and adult patients is characterized by a progressive decline in kidney function, classified according to the Kidney Disease: Improving Global Outcomes (KDIGO) in a system based primarily on glomerular filtration rate (eGFR, ml/min/1.73 m 2 ) and on proteinuria (1). The classification consists of 5 stages based on a decreasing of eGFR: G1 normal or high (≥ 90); G2 mildly decreased (60-89); G3a mildly to moderately decreased (45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59); G3b moderately to severely decreased (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44); G4 severely decreased (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) and G5 kidney failure (≤ 15, or dialysis) (1). According to these Guidelines, CKD should be established based on kidney function and damage expressed as eGFR, irrespective of...…”

Section: Introductionmentioning

confidence: 99%

Summary of Expert Opinion on the Management of Children With Chronic Kidney Disease and Growth Failure With Human Growth Hormone

et al. 2020

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Background: The management of children and adolescents with chronic kidney disease (CKD) and growth failure candidate for recombinant human growth hormone therapy (rhGH) is based on an appraisal of the literature established on a 2006 consensus statement and 2019 Clinical practice recommendations. The performance of these guidelines has never been tested. Aims: The objective of this study was to establish the level of adherence to international guidelines based on the 2006 consensus and the 2019 criteria that lead to the initiation of growth hormone treatment by both pediatric endocrinologists and pediatric nephrologists. Methods: A multidisciplinary team of pediatric endocrinologists and pediatric nephrologists, members of the Italian Society of Pediatric Endocrinology or of the Italian Society of Pediatric Nephrology, discussed and reviewed the main issues related to the management of pediatric patients with CKD who need treatment with rhGH. Experts developed 11 questions focusing on risk assessment and decision makings in October 2019 and a survey was sent to forty pediatric endocrinologists (n = 20) and nephrologists (n = 20) covering the whole national territory. The results were then analyzed and discussed in light of current clinical practice guidelines and recent recommendations. Results: Responses were received from 32 of the 40 invited specialists, 17 of whom were pediatric endocrinologists (42.5%) and 15 pediatric nephrologists (37.5%). Cappa et al. rhGH in Chronic Renal Disease Although all the centers that participated in the survey agreed to follow the clinical and biochemical diagnostic work-up and the criteria for the treatment of patients with CKD, among the Italian centers there was a wide variety of decision-making processes. Conclusions: Despite current guidelines for the management of children with CKD and growth failure, its use varies widely between centers and rhGH is prescribed in a relatively small number of patients and rarely after kidney transplantation. Several raised issues are not taken into account by international guidelines and a multidisciplinary approach with mutual collaboration between specialists will improve patient care based on their unmet needs.

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Growth hormone therapy in chronic renal failure induces catch-up of head circumference

Cited by 6 publications

References 25 publications

Recombinant human growth hormone therapy in autosomal recessive polycystic kidney disease

Recombinant human growth hormone therapy in autosomal recessive polycystic kidney disease

Neurodevelopmental Status and Adaptive Behaviors in Preschool Children with Chronic Kidney Disease

Summary of Expert Opinion on the Management of Children With Chronic Kidney Disease and Growth Failure With Human Growth Hormone

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