Long-term growth hormone treatment in short children with CKD does not accelerate decline of renal function: results from the KIGS ... View Full Text


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Article Info

DATE

2015-12

AUTHORS

Otto Mehls, Anders Lindberg, Dieter Haffner, Franz Schaefer, Elke Wühl, for members of the German KIGS Board, ESCAPE Trial Group

ABSTRACT

BACKGROUND: Recombinant human (rh) growth hormone (GH) raises the glomerular filtration rate (GFR) in healthy individuals. Concern has been raised that long-term rhGH treatment in short children with chronic kidney disease (CKD) may accelerate the progression of CKD via induction of glomerular hyperfiltration. PATIENTS AND METHODS: We compared the decline in GFR in children with CKD enrolled in two large clinical studies with (KIGS registry) and without (ESCAPE trial) concomitant rhGH treatment and followed for up to 10 years. Estimated GFR (eGFR) was determined at yearly intervals. The annual decline in eGFR was analyzed cross-sectionally for up to 10 years and longitudinally for 5 years. RESULTS: In the KIGS registry 367 patients with CKD stages II-IV (mean age 8.0 years; 72% boys; mean eGFR 38.4 ml/min/1.73 m(2)) were treated with 0.33 mg rhGH/kg per week for at least 1 year. In the ESCAPE trial 274 non-rhGH-treated patients with CKD stages II-IV (mean age 11.6 years; 61% boys; mean GFR 47.3 ml/min/1.73 m(2)) were followed for at least 1 year. At the 5-year follow-up, the mean loss of eGFR in the KIGS children receiving continuous rhGH treatment (n = 97) did not differ significantly from that in the controls (n = 113) in the ESCAPE trial (-5.8 vs. -8.6 ml/5 years, respectively; p = 0.17). Absolute height and eGFR at baseline were significant correlates of the annual eGFR loss (model R (2) =0.121). CONCLUSIONS: Long-term rhGH-treatment does not accelerate the decline in GFR in short children with CKD. Height and baseline eGFR are significant predictors of the loss of GFR in CKD patients. More... »

PAGES

2145-2151

References to SciGraph publications

  • 1986-10. Chronic effects of dietary protein in the rat with intact and reduced renal mass in KIDNEY INTERNATIONAL
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  • 1995-08. Differential effects of recombinant human growth hormone on glomerular filtration rate and renal plasma flow in chronic renal failure in PEDIATRIC NEPHROLOGY
  • 2003-09. Human GH pulsatility: An ensemble property regulated by age and gender in JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION
  • 1989-03. The delayed effect of growth hormone on renal function in humans in KIDNEY INTERNATIONAL
  • 2013-11. Epiphyseal growth plate growth hormone receptor signaling is decreased in chronic kidney disease–related growth retardation in KIDNEY INTERNATIONAL
  • 2005-03. Long-term use of recombinant human growth hormone in pediatric allograft recipients: a report of the NAPRTCS Transplant Registry in PEDIATRIC NEPHROLOGY
  • 2005-03. Growth hormone/insulin-like growth factor system in children with chronic renal failure in PEDIATRIC NEPHROLOGY
  • 1996-03. Long-term treatment of growth retarded children with chronic renal insufficiency, with recombinant human growth hormone in KIDNEY INTERNATIONAL
  • 1997-05. Somatic and renal effects of growth hormone in rats with chronic renal failure in PEDIATRIC NEPHROLOGY
  • 1998-04. Treatment with Recombinant Human Growth Hormone in Short Children with Nephropathic Cystinosis: No Evidence for Increased Deterioration Rate of Renal Function in PEDIATRIC RESEARCH
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00467-015-3157-8

    DOI

    http://dx.doi.org/10.1007/s00467-015-3157-8

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1047608381

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/26198275


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