Mehls O, Broyer M
Division of Paediatric Nephrology, University Children's Hospital, Heidelberg, Germany.
Acta Paediatr Suppl. 1994 Apr;399:81-7. doi: 10.1111/j.1651-2227.1994.tb13299.x.
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.
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。