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 language | English (US) |
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Pages (from-to) | 2323-2333 |
Number of pages | 11 |
Journal | Pediatric Nephrology |
Volume | 28 |
Issue number | 12 |
DOIs | |
State | Published - Dec 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