Riedl M, Hass M, Oberbauer R, Gisinger J, Luger A, Mayer G
Department of Internal Medicine III, University Hospital of Vienna, Austria.
J Am Soc Nephrol. 1995 Nov;6(5):1434-8. doi: 10.1681/ASN.V651434.
Twelve growth hormone (GH)-deficient adults with normal renal function were recruited for a 6-month, double-blind, placebo-controlled study on the effects of prolonged recombinant human growth hormone (rhGH) substitution therapy on renal functional parameters. RhGH was administered at a dose 0.125 IU/kg per week sc the first 4 wk and 0.25 IU/kg per week thereafter. At baseline and after 6 months of therapy, GFR and RPF were measured by the use of iothalamate and para- aminohippurate clearance techniques before and after an intravenous infusion of amino acids (AA) to determine the renal functional reserve capacity (RFRC). At baseline, GFR and RPF were similar in the GH-deficient patients and a group of normal, healthy controls (GFR, 117 +/- 10 mL/min; RPF, 567 +/- 57 mL/min, and filtration fraction, 22 +/- 1.6% in the patient group and GFR, 117 +/- 10 mL/min; RPF, 509 +/- 54 mL/min; and filtration fraction, 24 +/- 1.3% in the control group). GFR increased significantly in the control and patient group after AA infusion; the RFRC, however, was significantly larger in healthy individuals (GFR post-AA infusion, 141 +/- 10 mL in GH-deficient patients and 182 +/- 20 mL/min in controls). Thereafter, six patients received placebo therapy for 6 months and GFR as well as RFRC remained constant (GFR, 107 +/- 9 and 106 +/- 12 mL/min before AA infusion and 132 +/- 14 and 134 +/- 5 mL/min after AA infusion at baseline and after 6 months, respectively). Four patients of the placebo group then continued with rhGH therapy for another 6 months. They and six patients who had rhGH therapy from the beginning form the rhGH treatment study group. During rhGH treatment, plasma insulin-like growth factor activity increased significantly from 93 +/- 17 to 229 +/- 23 ng/mL. Baseline GFR and RPF as well as RFRC were unaltered by the 6 months of rhGH replacement therapy (basal GFR, 124 +/- 7 mL/min before and 123 +/- 9 mL/min after 6 months of rhGH therapy; GFR after AA infusion, 145 +/- 9 mL/min at baseline and 144 +/- 8 mL/min after 6 months of therapy). Kidney size as evaluated by ultrasonography was normal at baseline when compared with that in age- and sex-matched controls (10.3 +/- 0.2 versus 9.9 +/- 0.1 cm) and was unchanged after 6 months of therapy (10.3 +/- 0.3 cm). It was concluded from this study that rhGH substitution for 6 months at a dose of 0.25 IU/kg per week in GH-deficient patients with normal renal function has no adverse functional effects on the kidney.
招募了12名肾功能正常的生长激素（GH）缺乏成年患者，进行一项为期6个月的双盲、安慰剂对照研究，以探讨长期重组人生长激素（rhGH）替代疗法对肾功能参数的影响。rhGH给药剂量为前4周每周皮下注射0.125 IU/kg，之后每周0.25 IU/kg。在基线期和治疗6个月后，通过静脉输注氨基酸（AA）前后使用碘肽酸盐和对氨基马尿酸清除技术测量肾小球滤过率（GFR）和肾血浆流量（RPF），以确定肾功能储备能力（RFRC）。基线期，GH缺乏患者与一组正常健康对照者的GFR和RPF相似（患者组GFR为117±10 mL/min，RPF为567±57 mL/min，滤过分数为22±1.6%；对照组GFR为117±10 mL/min，RPF为509±54 mL/min，滤过分数为24±1.3%）。AA输注后，对照组和患者组的GFR均显著增加；然而，健康个体的RFRC显著更大（GH缺乏患者AA输注后GFR为141±10 mL/min，对照组为182±20 mL/min）。此后，6名患者接受了6个月的安慰剂治疗，GFR和RFRC保持不变（基线期和6个月后，AA输注前GFR分别为10
