The utility of the IGF-I generation test in children with chronic kidney disease

Amira Al-Uzri, Rita D. Swinford, Thuan Nguyen, Randall Jenkins, Anthony Gunsul, Svetlana S. Kachan-Liu, Ron Rosenfeld

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background: To determine if the insulin-like-growth factor (IGF-I) generation test is a marker for growth hormone (GH) sensitivity in children with chronic kidney disease (CKD). Methods: This was a randomized cross-over study in which children with CKD received low-dose (0.025 mg/kg/day) and high-dose (0.05 mg/kg/day) GH therapy in the framework of a 7-day IGF-I generation test. Blood samples were collected on day 1 (D1; pre-dose) and on day 8 (D8; post 7 doses) of GH therapy. All subjects received GH for 12 months at 0.05 mg/kg/day. Serum IGF-I was measured by radioimmunometric assay. Normative historic data from healthy children and those with idiopathic short stature were used for comparison. Results: Sixteen subjects (age 2-13 years) with creatinine clearances of between 25 and 75 ml/min/1.73 m2 were enrolled. Annualized height velocity for all subjects was 10.3 ±1.1 cm/year (mean ± standard deviation), with an annual change in height Z score of 0.7 ± 1.0. No correlation was found between the generated serum IGF-I levels (D8 - D1) and creatinine clearances, and with changes in height Z scores. Serum IGF-I levels on D1 and D8 in CKD subjects were lower than normative data, but with adequate IGF-I generation on D8. Conclusions: Children with CKD were able to respond to GH therapy with both growth and an increase in serum IGF-I levels, but the IGF-I generation test was not a good predictor of growth response in this cohort.

Original languageEnglish (US)
Pages (from-to)2323-2333
Number of pages11
JournalPediatric Nephrology
Volume28
Issue number12
DOIs
StatePublished - Dec 1 2013

Keywords

  • Annual height velocity
  • Children
  • Chronic kidney disease
  • Growth
  • Growth hormone
  • IGF-I generation test
  • Insulin-like growth factor I

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

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