Improvement in growth after 1 year of growth hormone therapy in well-nourished infants with growth retardation secondary to chronic renal failure: results of a multicenter, controlled, randomized, open clinical trial.

Fernando Santos, M Llanos Moreno, Arlete Neto, Gema Ariceta, Julia Vara, Angel Alonso, Alberto Bueno, Alberto Caldas Afonso, António Jorge Correia, Rafael Muley, Vicente Barrios, Carlos Gómez, Jesús Argente

Journal: Clinical journal of the American Society of Nephrology : CJASN 2010;5(7):1190-7

PMID: 20522533

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Abstract

BACKGROUND AND OBJECTIVES

Our aim was to evaluate the growth-promoting effect of growth hormone (GH) treatment in infants with chronic renal failure (CRF) and persistent growth retardation despite adequate nutritional and metabolic management.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

The study design included randomized, parallel groups in an open, multicenter trial comparing GH (0.33 mg/kg per wk) with nontreatment with GH during 12 months. Sixteen infants who had growth retardation, were aged 12+/-3 months, had CRF (GFR

RESULTS

Length gain in infants who were treated with GH was statistically greater (P<0.05) than that of nontreated children (14.5 versus 9.5 cm/yr; SD score 1.43 versus -0.11). The GH-induced stimulation of growth was associated with no undesirable effects on bone maturation, renal failure progression, or metabolic control. In addition, GH treatment improved forearm bone mass and increased serum concentrations of total and free IGF-I and IGF-binding protein 3 (IGFBP-3), whereas IGF-II, IGFBP-1, IGFBP-2, GH-binding protein, ghrelin, and leptin were not modified.

CONCLUSIONS

Infants with CRF and growth retardation despite good metabolic and nutritional control benefit from GH treatment without adverse effects during 12 months of therapy.

Address: Department of Pediatric Nephrology, Hospital Universitario Central de Asturias, Universidad de Oviedo, Celestino Villamil, s/n, E33006 Oviedo, Spain. [email protected]

DOI: 10.2215/CJN.07791109

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MeSH Terms: Absorptiometry, Photon, Arm Bones, Biomarkers, Body Height, Body Weight, Bone Density, Chi-Square Distribution, Enzyme-Linked Immunosorbent Assay, Female, Glomerular Filtration Rate, Growth Disorders, Human Growth Hormone, Humans, Infant, Infant Nutritional Physiological Phenomena, Kidney Failure, Chronic, Male, Nutritional Status, Portugal, Prospective Studies, Radioimmunoassay, Spain, Tarsal Bones, Time Factors, Treatment Outcome