Bone mineral density, bone metabolism and body composition of children with chronic renal failure, with and without growth hormone treatment

Boot, Annemieke M.; Nauta, Jeroen; Jong, M. C. J. W. de; Groothoff, Jaap W.; Lilien, M. R.; Wijk, J. A. E. van; Holthe, Joana E. Kist-van; Hokken-Koelega, Anita; Pols, H. A. P.; Keizer‐Schrama, Sabine M.P.F. de Muinck

doi:10.1046/j.1365-2265.1998.00593.x

Cited by 33 publications

(35 citation statements)

References 35 publications

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“…The differences in these results may be explained by differences in the populations studied. Our observation of low-normal serum IGF-I levels before and an increase during the 1st year of hGH treatment was comparable to that previously described in CRF [9,22,23,24] and our short non-GHD patients with Turner or Noonan syndrome [3]. The increase in serum IGF-I during treatment was lower than that observed in children with GHD (mean change +4.4 SDS) [3].…”

Section: Discussionsupporting

confidence: 91%

Serum leptin and IGF-I during growth hormone treatment in chronic renal failure

et al. 2002

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Serum leptin decreases during growth hormone (hGH) treatment and pre-treatment values have been suggested as a predictor of the response to hGH in GH deficiency (GHD) but not in non-GHD syndromes. To investigate whether this holds true in children with chronic renal failure (CRF), we evaluated changes in serum leptin, insulin-like growth factor-I (IGF-I) and height before(b) and during the 1st year (3 months, 6 months, 9 months, 12 months) of hGH treatment (1 IU/kg per week) in 11 children (median age(b) 10.1 years, mean height(b) -2.9 SDS) with CRF. Serum leptin and IGF-I were compared with values from healthy children. Each patient also served as his/her own control, with values during treatment compared with those before treatment. Growth improved in all patients during treatment (mean change(12 m) +7.2 cm, change in height SDS(12 m) +0.5, P=0.001). Weight decreased (median decrease(12 m) 0.3 SDS, P=0.02) but body mass index (BMI) and serum leptin did not change during treatment. Serum IGF-I levels were low before (mean -1.1 SDS) but increased during hGH treatment, the increment being greatest at 10 days (mean increment +1.9 SDS, P<0.0001). Serum leptin(b) did not correlate with change in serum IGF-I(10d), height(12 m) or weight(12 m). Serum IGF-I SDS(b) correlated with height SDS at 12 months ( r=0.80, P=0.006) of hGH treatment. Serum leptin(b) correlated with BMI ( r(s)=0.75, P=0.01). Levels adjusted for BMI did not differ from values in healthy children and did not change during treatment. Despite an IGF-I and growth response during hGH treatment, serum leptin did not change and pre-treatment values did not predict the growth response in these children with CRF.

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Section: Discussionsupporting

confidence: 91%

Serum leptin and IGF-I during growth hormone treatment in chronic renal failure

et al. 2002

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“…Data on bone composition in infants with CRF and the effect of GH are not available in the literature. In small series of older prepubertal children with CRF, bone mineral density of lumbar spine increased (37) or remained unchanged (38) with GH therapy. In our study, the growth-promoting effect of GH was initially accompanied by an increase in bone area and bone mineral content that reflected the stimulus of GH on longitudinal growth.…”

Section: Discussionmentioning

confidence: 99%

Improvement in Growth After 1 Year of Growth Hormone Therapy in Well-Nourished Infants with Growth Retardation Secondary to Chronic Renal Failure

Santos¹,

Moreno²,

Neto³

et al. 2010

Clinical Journal of the American Society of Nephrology

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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 <60 ml/min per 1.73 m 2 ), and had adequate nutritional intake and good metabolic control were recruited from eight pediatric nephrology departments from Spain and Portugal. Main outcome measures were body length, body weight, bone age, biochemical and hormonal analyses, renal function, bone mass, and adverse effects.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.

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“…DEXA has been used by many investigators for the evaluation of BMD in adults with CRF [4,5,6,7,8,9]. Few studies of DEXA in children with CRF have been published [10,11,12,13].…”

Section: Introductionmentioning

confidence: 99%

Bone mineral density and bone turnover markers in children with chronic renal failure

Bakr

2004

Pediatr Nephrol

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Bone mineral density (BMD) at lumbar spine (L2-L4) was measured by dual-energy X-ray absorptiometry (DEXA) in 21 children with predialysis chronic renal failure (CRF) and 44 children with end-stage renal failure (ESRF) on regular hemodialysis. BMD results were expressed as Z-scores. Osteopenia was documented in 13 predialysis patients (61.9%) and 26 patients (59.1%) with ESRF. No significant correlation was observed between Z-scores and the duration of CRF or estimated creatinine clearance. In osteopenic children there was a negative correlation between Z-scores and serum phosphorus (r=-0.61, P=0.004), intact parathyroid hormone (iPTH) (r=-0.47, P=0.03), and bone-specific alkaline phosphatase (r=-0.52, P=0.02) and a positive correlation with total calcium (r=0.41, P=0.07) and 25-hydroxycholecalciferol (r=0.53, P=0.02). Osteopenic children who had iPTH values > or = 200 pg/ml were more osteopenic than those who had lower iPTH levels (P=0.006). In conclusion, osteopenia, assessed by DEXA, is frequent in children with CRF. It occurs early irrespective of the duration or the severity of CRF. In children with ESRF the degree of osteopenia is correlated with laboratory markers of renal osteodystrophy and patients with biochemical findings of secondary hyperparathyroidism are more osteopenic than the others.

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Bone mineral density, bone metabolism and body composition of children with chronic renal failure, with and without growth hormone treatment

Cited by 33 publications

References 35 publications

Serum leptin and IGF-I during growth hormone treatment in chronic renal failure

Serum leptin and IGF-I during growth hormone treatment in chronic renal failure

Improvement in Growth After 1 Year of Growth Hormone Therapy in Well-Nourished Infants with Growth Retardation Secondary to Chronic Renal Failure

Bone mineral density and bone turnover markers in children with chronic renal failure

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