Department of Endocrinology, Hospital Nacional de Pediatria J.P.Garrahan, C. de los Pozos 1881, C1245AAM, Buenos Aires, Argentina.
Department of Nephrology, Hospital Nacional de Pediatria J.P.Garrahan, Buenos Aires, Argentina.
Pediatr Nephrol. 2018 Jan;33(1):175-180. doi: 10.1007/s00467-017-3777-2. Epub 2017 Aug 18.
Growth retardation and its impact on adult height is considered to be one of the most common complications in patients with chronic kidney disease (CKD). Treatment with recombinant human growth hormone (rhGH) has been effective in improving growth in kidney transplantation (KTx) patients, but little data are available on adult height in patients who began rhGh treatment in late puberty.
Near-adult height was evaluated in 13 KTx patients treated with rhGH [growth hormone group (GHGr); dose 9.33 mg/m per week] for a period of at least 18 months. At initiation of rhGH treatment, testicular volume was >8 ml and serum testosterone was >1 ng/ml compared with the control group (CGr) of ten KTx patients who did not receive rHGH. All subjects were of similar chronological age and bone age and had similar creatinine clearance (CrCl) levels, cumulative corticoid dose, height standard deviation score (SDS), target height SDS, and target height:initial height at the beginning of the study.
Near-adult height was significantly greater in the GHGr than in the CGr (-1.8 ± 0.8 vs. -2.9 ± 1.1; p = 0.018). The difference between initial height and near-adult height in the GHGr revealed a significant height gain (initial height -3.1 ± 1.1; near-adult height -1.8 ± 0.8 SDS, respectively; delta 1.2 ± 0.3; p = 0.021). The CrCl level was not significantly different between the GHGr and CGr at either at study initiation or when attaining near-adult height (p = 0.74 and p = 0.23, respectively).
Treatment with rhGH was effective in improving adult height in KTx patients who began treatment in late puberty, without any effect on renal function.
生长迟缓及其对成人身高的影响被认为是慢性肾脏病(CKD)患者最常见的并发症之一。重组人生长激素(rhGH)治疗已被证明可有效改善肾移植(KTx)患者的生长,但关于青春期后期开始 rhGH 治疗的患者的成年身高数据较少。
评估了 13 名接受 rhGH [生长激素组(GHGr);每周 9.33mg/m]治疗至少 18 个月的 KTx 患者的接近成年身高。在开始 rhGH 治疗时,与未接受 rhGH 的 10 名 KTx 患者的对照组(CGr)相比,睾丸体积>8ml,血清睾酮>1ng/ml。所有受试者的实际年龄和骨龄相似,肌酐清除率(CrCl)水平、累积皮质激素剂量、身高标准差评分(SDS)、目标身高 SDS 和研究开始时的目标身高:初始身高相似。
GHGr 的接近成年身高明显高于 CGr(-1.8±0.8 对-2.9±1.1;p=0.018)。GHGr 初始身高与接近成年身高之间的差异显示出显著的身高增长(初始身高-3.1±1.1;接近成年身高-1.8±0.8 SDS,分别;差值 1.2±0.3;p=0.021)。在研究开始时和接近成年身高时,GHGr 和 CGr 的 CrCl 水平均无显著差异(分别为 p=0.74 和 p=0.23)。
rhGH 治疗可有效改善青春期后期开始治疗的 KTx 患者的成年身高,对肾功能无影响。