Jedrzejowski Antoni, Dyras Paweł, Pańczyk-Tomaszewska Małgorzata, Mizerska-Wasiak Małgorzata, Roszkowska-Blaim Maria, Pietrzyk Jacek A, Gałazka Barbara
Katedra i Klinika Pediatrii i Nefrologii Akademii Medycznej w Warszawie.
Pol Merkur Lekarski. 2002 Sep;13(75):191-5.
The aim of this work was to assess the effect of recombinant human growth hormone (rhGH) on the kinetics of urea and creatinine and selected indices of dialysis adequacy in children with end-stage renal failure treated with peritoneal dialysis. We studied 24 children on peritoneal dialysis, including 10 children aged 9-15.7 years (mean age 12.5 years) treated with 1-1.1 IU/kg/week of rhGH administered daily for 6 months. The control group included 14 patients aged 5.4-18.3 years (mean age 12.6 years). Kinetic modelling of urea and creatinine using Adequest was performed in all patients at baseline and after 3 and 6 months of follow-up. Total dialysate and urinary excretion of urea and creatinine (tUE and tCE, mg/min), total urea and creatinine clearance (tUC and tCC, L/week), weekly Kt/V, normalized total weekly creatinine clearance (ntCC, L/week/1.73 m2), total body water (TBW, kg), and absolute and percent change of TBW (DTBW, kg, and D%TBW, respectively) were calculated. Albumin level was measured and diet composition was analysed in all patients. Insignificant decrease in Kt/V was found after 3 and 6 months of rhGH treatment despite stable values of tUC (45.3 +/- 15 L/week vs 45.6 +/- 15 L/week, p = NS). Serum creatinine increased from 7.38 +/- 1.52 to 9.26 +/- 2.98 mg/dL after 6 months of rhGH treatment. Significantly higher values of delta %TBW were found among treated patients compared to the control group (1.23 +/- 0.7 kh vs 0.57 +/- 0.7 kg, P < 0.05). delta TBW in patients treated with rhGH was significantly higher during months 0-3 compared to months 3-6 (0.85 +/- 0.6 kg and 0.38 +/- 0.17 kg, respectively, p < 0.05). No significant changes in ntCC, albumin concentration and diet composition were found.
本研究旨在评估重组人生长激素（rhGH）对终末期肾衰竭接受腹膜透析治疗儿童的尿素和肌酐动力学以及选定的透析充分性指标的影响。我们研究了24例接受腹膜透析的儿童，其中10例年龄在9至15.7岁（平均年龄12.5岁），每天接受1 - 1.1 IU/kg/周的rhGH治疗，持续6个月。对照组包括14例年龄在5.4至18.3岁（平均年龄12.6岁）的患者。在所有患者的基线以及随访3个月和6个月后，使用Adequest对尿素和肌酐进行动力学建模。计算尿素和肌酐的总透析液和尿排泄量（tUE和tCE，mg/min）、总尿素和肌酐清除率（tUC和tCC，L/周）、每周Kt/V、标准化每周总肌酐清除率（ntCC，L/周/1.73 m²）、总体水（TBW，kg）以及TBW的绝对变化和百分比变化（分别为DTBW，kg和D%TBW）。测量所有患者的白蛋白水平并分析饮食组成。rhGH治疗3个月和6个月后，尽管tUC值稳定（45.3±15 L/周对45.6±15 L/周，p =无统计学意义）但Kt/V有不显著下降。rhGH治疗6个月后血清肌酐从7.38±1.52 mg/dL升至9.26±2.98 mg/dL。与对照组相比，治疗组患者的δ%TBW值显著更高（1.23±0.7 kg对0.57±0.7 kg，P < 0.05）。接受rhGH治疗的患者在0至3个月期间的δTBW显著高于3至6个月期间（分别为0.85±0.6 kg和0.38±0.17 kg，p < 0.05）。ntCC、白蛋白浓度和饮食组成无显著变化。
