Abstract
Children with CRF grow poorly and, frequently, neither dialysis nor Tx improve growth. It has been proposed that these children have target organ resistance to the effects fo GH/IGF-I which could be overcome by supraphysiological doses of GH. Our objective was to evaluate growth response and renal function after GH treatment (1 IU/Kg. week) in patients with CRF after Tx. Seven patients (5 prepubertal and 2 pubertal children) were studied: mean ± SD chronological age (A) 12.2±3.25 years (y), bone A 8.47±3.94 y, height SDS −3.82±1.44 and post Tx time 1.99±2.16 y. All patients had normal serum T4 and T3 levels and GH responses to pharmacological tests (> 7 ng/ml). Mean GH treatment time was 7.0±3.46 moths. Parameters of biological actions of GH (growth velocity : GV, serum levels of SHBG and IGF-1) and of renal function (Cr cl) were evaluated before and after treatment. Findings were as follows: a significative increment in GV (from 2.46±0.63 to 7.42±1.68 cm/y, p< 0.001, ANOVA), similar CrCI (96.2±12.9 and 100.6±25.8 ml/min. 1.73m ), a significant decrement in serum SHBG (from 75.9±32.4 to 55.5±31.5 nmol/L, p<0.01) and a non significant increment in serum IGF-I (from 220± 66.5 to 305±142.5 ng/ml). It is concluded that GH treatment at supraphysiological doses in CRF patients after TX does increase GV without changing functions parameters of the transplanted kidney. Serum SHBG is a biological response parameter to GH.
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