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慢性肾功能衰竭的青春期前儿童(无论是否接受透析)对重组人生长激素的生长反应。欧洲/澳大利亚研究小组。

Growth response to recombinant human growth hormone in short prepubertal children with chronic renal failure with or without dialysis. The European/Australian Study Group.

作者信息

Mehls O, Broyer M

机构信息

Division of Paediatric Nephrology, University Children's Hospital, Heidelberg, Germany.

出版信息

Acta Paediatr Suppl. 1994 Apr;399:81-7. doi: 10.1111/j.1651-2227.1994.tb13299.x.

DOI:10.1111/j.1651-2227.1994.tb13299.x
PMID:7949624
Abstract

The growth-promoting effect of recombinant human growth hormone (GH) in children with chronic renal failure was assessed in eight clinical trials. A total of 103 prepubertal children participated in the trials, 34 of whom were undergoing dialysis. The children were treated with GH, 30 IU/m2/week (approximately 1 IU/kg/week), for up to 2 years, and various growth parameters, bone age and renal function were assessed before and during treatment. In all trials, the children showed clear catch-up growth and an improved height SDS after treatment with GH, although the increase in height was less in dialysis patients than in those not receiving dialysis. GH maintained its growth-promoting effect during the second year of treatment; the effect, however, was less marked than during the first year of treatment. Bone age appeared to advance in parallel with chronological age. Median serum creatinine increased from 204 mumol/l to 230 and 262 mumol/l after 12 and 24 months of treatment, respectively, due to increased muscle mass and/or progression of the underlying renal disease. The loss of estimated glomerular filtration rate/year was not different before and during GH treatment.

摘要

八项临床试验评估了重组人生长激素(GH)对慢性肾衰竭儿童的促生长作用。共有103名青春期前儿童参与了试验,其中34名正在接受透析治疗。这些儿童接受GH治疗,剂量为30 IU/m²/周(约1 IU/kg/周),治疗长达2年,并在治疗前和治疗期间评估了各种生长参数、骨龄和肾功能。在所有试验中,儿童在接受GH治疗后均表现出明显的追赶生长,身高标准差得分有所改善,尽管透析患者的身高增长低于未接受透析的患者。在治疗的第二年,GH仍保持其促生长作用;然而,其效果不如治疗的第一年明显。骨龄似乎与实际年龄同步增长。由于肌肉量增加和/或潜在肾脏疾病的进展,治疗12个月和24个月后,血清肌酐中位数分别从204 μmol/L增至230 μmol/L和262 μmol/L。GH治疗前和治疗期间每年估计肾小球滤过率的下降没有差异。

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Growth in renal failure: a longitudinal study of emotional and behavioural changes during trials of growth hormone treatment.肾衰竭患者的生长情况:生长激素治疗试验期间情绪和行为变化的纵向研究
Arch Dis Child. 1998 Mar;78(3):222-9. doi: 10.1136/adc.78.3.222.
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Is severe renal osteodystrophy a contraindication for recombinant human growth hormone treatment?
Pediatr Nephrol. 1996 Jun;10(3):351-4. doi: 10.1007/BF00866781.
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Short dialyzed children respond less to growth hormone than patients prior to dialysis. German Study Group for Growth Hormone Treatment in Chronic Renal Failure.短期透析的儿童对生长激素的反应比透析前的患者要小。德国慢性肾衰竭生长激素治疗研究小组。
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