본문 바로가기
KERD
논문KCI 등재

만성 복막투석 환자에서 성장호르몬 치료의 효과와성장에 영향을 주는 요인에 대한 연구

The Effect of Growth Hormone and the Factors InfluencingGrowth in Pediatric Chronic Peritoneal Dialysis Patients

박성원|손영배|진동규|백경훈|김수진
대한소아신장학회 (The Korean Society Of Pediatric Nephrology)|2008.04|Childhood Kidney Diseases (Childhood Kidney diseases)|제12권 제1호|pp. 38-46

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

Growth hormoneChronic renal failurePeritoneal dialysisResidual renal functionGrowth hormone treatment
주제분류소아과학

초록

Purpose : Growth failure is a common problem in chronic renal failure(CRF). We studied the effect of growth hormone(GH) treatment and the factors influencing growth on chronic peritoneal dialysis patients. Methods : Seventeen patients who were treated with peritoneal dialysis and GH for more than one year were enrolled. Factors influencing growth such as age, height at start of GH treatment, total Kt/Vurea, residual renal Kt/Vurea, hemoglobin, albumin, BUN, creatinine, total CO2, calcium, phosphate and iPTH during GH treatment were compared between the growth group(increase in height-standard deviation score(Ht-SDS) after one year of GH treatment, n=11) and poor growth group(no increase in Ht-SDS after one year of GH treatment, n=6). Results : The mean age at the start of dialysis was 7.7±5.2 years and the mean age at the start of GH treatment was 8.5±4.8 years. In the growth group, Ht-SDS at start of GH treatment was smaller(-1.72±1.00 vs. -0.77±0.88, P=0.048) and residual renal Kt/Vurea was better (1.54±0.51 vs. 0.15±0.26, P=0.02) than the poor growth group. After three years of GH treatment, Ht-SDS of the growth group was better than the poor growth group. Conclusion : GH treatment in children with peritoneal dialysis was more effective on patients who had more severe growth retardation. The reservation of residual renal function was important for improvement of effect of GH treatment. And the growth response during the first year of GH treatment may be predicted as the indicator for long-term response.

Abstract

Purpose : Growth failure is a common problem in chronic renal failure(CRF). We studied the effect of growth hormone(GH) treatment and the factors influencing growth on chronic peritoneal dialysis patients. Methods : Seventeen patients who were treated with peritoneal dialysis and GH for more than one year were enrolled. Factors influencing growth such as age, height at start of GH treatment, total Kt/Vurea, residual renal Kt/Vurea, hemoglobin, albumin, BUN, creatinine, total CO2, calcium, phosphate and iPTH during GH treatment were compared between the growth group(increase in height-standard deviation score(Ht-SDS) after one year of GH treatment, n=11) and poor growth group(no increase in Ht-SDS after one year of GH treatment, n=6). Results : The mean age at the start of dialysis was 7.7±5.2 years and the mean age at the start of GH treatment was 8.5±4.8 years. In the growth group, Ht-SDS at start of GH treatment was smaller(-1.72±1.00 vs. -0.77±0.88, P=0.048) and residual renal Kt/Vurea was better (1.54±0.51 vs. 0.15±0.26, P=0.02) than the poor growth group. After three years of GH treatment, Ht-SDS of the growth group was better than the poor growth group. Conclusion : GH treatment in children with peritoneal dialysis was more effective on patients who had more severe growth retardation. The reservation of residual renal function was important for improvement of effect of GH treatment. And the growth response during the first year of GH treatment may be predicted as the indicator for long-term response.

참고문헌 (34)

  1. Kleinknecht C, "Growth in children treated with long-term dialysis. A study of 76 patients", Adv Nephrol Necker Hosp, 9, pp.133~163 (1980)
  2. Furth SL, "Growth failure, risk of hospitalization and death for children with end-stage renal disease", Pediatr Nephrol, 17, pp.450~455 (2002)
  3. Stefanidis CJ, "Growth of prepubertal children on dialysis", Pediatr Nephrol, 22, pp.1251~1259 (2007)
  4. Warady BA, "Pediatric Dialysis", pp.259~278 (2004), Kluwer Academic Publishers
  5. Stefanidis CJ, "Kidney disorders in children and adolescents", pp.215~223 (2006), Tayler & Francis
  6. Yang SW, "The effect of recombinant human growth hormone on the growth in the children with chronic renal failure", Korean Journal of Pediatrics, 36, pp.997~1004 (1993)
  7. Mahesh S, "Growth hormone axis in chronic kidney disease", Pediatr Nephrol, 23, pp.41~48 (2008)
  8. Fouque D., "Insulin-like growth factor 1 resistance in chronic renal failure", Miner Electrolyte Metab, 22, pp.133~137 (1996)
  9. Tonshoff B, "Growth-stimulating effects of recombinant human growth hormone in children with end-stage renal disease", J Pediatr, 116, pp.561~566 (1990)
  10. Stefanidis CJ, "Growth in children receiving continuous ambulatory peritoneal dialysis", J Pediatr, 102, pp.681~685 (1983)
  11. Norman LJ, "Nutrition and growth in relation to severity of renal disease in children", Pediatr Nephrol, 15, pp.259~265 (2000)
  12. Neu AM, "Chronic dialysis in children and adolescents. The 2001 NAPRTCS Annual Report", Pediatr Nephrol, 17, pp.656~663 (2002)
  13. Fine RN, "Five years experience with recombinant human growth hormone treatment of children with chronic renal failure", J Pediatr Endocrinol, 7, pp.1~12 (1994)
  14. Crompton CH., "Long-term recombinant human growth hormone use in Australian children with renal disease", Nephrology(Carlton), 9, pp.325~330
  15. Haffner D, "Effect of growth hormone treatment on the adult height of children with chronic renal failure. German Study Group for Growth Hormone Treatment in Chronic Renal Failure", N Engl J Med, 343, pp.923~930 (2000)
  16. Diez JJ, "Long-term effects of recombinant human erythropoietin therapy on growth hormone secretion in uremic patients undergoing peritoneal dialysis", Metabolism, 48, pp.210~216 (1999)
  17. Park MJ, "The growth hormone levels and the effect of growth hormone in the children with chronic renal failure", Journal of Korean Pediatric Endocrinology, 3, pp.28~36 (1998)
  18. Yang SW, "The effect of recombinant human growth hormone on the growth in the children with chronic renal failure", Korean Journal of Pediatrics, 39, pp.997~1004 (1996)
  19. Koh SH, "Short term effect of recombinant human growth hormone therapy in children with chronic renal failure", Korean Journal of Pediatrics, 41, pp.1256~1261 (1998)
  20. Klaus G, "Prevention and treatment of renal osteodystrophy in children on chronic renal failure: European guidelines", Pediatr Nephrol, 21, pp.151~159 (2006)
  21. Boehm M, "Early erythropoietin therapy is associated with improved growth in children with chronic kidney disease", Pediatr Nephrol, 22, pp.1189~1193 (2007)
  22. Bakr MA, "Growth in children with chronic renal failure and after renal transplantation", Int Urol Nephrol, 39, pp.635~639 (2007)
  23. Wong H, "Prevalence of complications in children with chronic kidney disease according to KDOQI", Kidney Int, 70, pp.585~590 (2006)
  24. Rusconi R, "Pubertal growth and final height in children with chronic renal failure on conservative treatment", J Pediatr Endocrinol Metab, 16(2), pp.271~276 (2003)
  25. Andre JL, "Final height in children with chronic renal failure who have not received growth hormone", Pediatr Nephrol, 18, pp.685~691 (2003)
  26. Smith JM, "Contributions of the Transplant Registry: The 2006 Annual Report of the North American Pediatric Renal Trials and Collaborative Studies(NAPRTCS)", Pediatr Transplant, 11, pp.366~373 (2007)
  27. Cansick J, "Growth and PTH in prepubertal children on long-term dialysis", Pediatr Nephrol, 22, pp.1349~1354 (2007)
  28. Mahan JD, "Assessment and treatment of short stature in pediatric patients with chronic kidney disease: a consensus statement", Pediatr Nephrol, 21, pp.917~930 (2006)
  29. Schaefer F, "Stimulation of growth by recombinant human growth hormone in children undergoing peritoneal or hemodialysis treatment. German Study Group for Growth Hormone Treatment in Chronic Renal Failure", Adv Perit Dial, 10, pp.321~326 (1994)
  30. Kari JA, "Growth hormone for children with chronic renal failure and on dialysis", Pediatr Nephrol, 20, pp.618~621 (2005)
  31. Schaefer F, "Long-term experience with growth hormone treatment in children with chronic renal failure", Perit Dial Int, 19(2), pp.S467~S472 (1999)
  32. Haffner D, "Factors predictive of the short- and long-term efficacy of growth hormone treatment in prepubertal children with chronic renal failure. The german study group for growth hormone treatment in chronic renal failure", J Am Soc Nephrol, 9, pp.1899~1907 (1998)
  33. Ranke MB, "Is there an auxological basis for growth-promoting treatment with human growth hormone in short children?", Acta Paediatr Scand Suppl, 367, pp.4~10 (1990)
  34. Hokken-Koelega AC, "Double blind trial comparing the effects of two doses of growth hormone in prepubertal patients with chronic renal insufficiency", J Clin Endocrinol Metab, 79, pp.1185~1190 (1994)

관련 논문AI추천

만성 소아 신질환 환자에서의 성장호르몬 치료정우영대한소아신장학회 · Childhood Kidney Diseases2009 · 제13권 제1호장기간의 스테로이드 치료를 받고 있는 신병증 환아에서 Recombinant Human Growth Hormone의 효과김선경, 김성도, 김세진, 조병수대한소아신장학회 · Childhood Kidney Diseases2006 · 제10권 제2호저신장 소아를 위한 성장호르몬 치료박용훈영남대학교 의과대학 · Journal of Yeungnam Medical Science2005 · 제22권 제1호소아복막투석의 현황: 다기관 공동연구 결과보고최용, 박영서, 백경훈, 유기환, 윤지석, 이주훈, 임형은, 정해일, 하일수대한소아신장학회 · Childhood Kidney Diseases2009 · 제13권 제2호Effect of growth hormone treatment on children with idiopathic short stature and idiopathic growth hormone deficiency김용대, 임민지, 한헌석대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2017 · 제22권 제2호Factors influencing growth hormone therapy effect during the prepubertal period in small for gestational age children without catch-up growthHwang Jin Soon, Kum Chang Dae, Lee Hae Sang, Park Hong Kyu, Rho Jung Gi대한소아내분비학회 · Annals of Pediatric Endocrinology & Metabolism2021 · 제26권 제1호

이 간행물의 다른 논문 (14건)

염색체 말단부위이미형, 서동철pp. 1-10신장 기능과 틸로미어서동철pp. 11-22신이식 후 면역반응의 이해- 1부. 이식 거부 반응의 기전-강희경pp. 23-29소아에서의 급성 신성신부전의 임상적 고찰권은지, 정지미, 정우영pp. 30-37대중매체를 통한 신장 관련 정보 제공 실태에 대한 고찰유기환, 홍영숙, 임형은, 임동희, 은백린, 정지인, 이주원pp. 47-53
원문 보기