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 m(2) 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.
RCT Entities:
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 m(2) 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.
Authors: Michael B Ranke; Roland Schweizer; David D Martin; Stefan Ehehalt; Carl-Philipp Schwarze; Felice Serra; Gerhard Binder Journal: Horm Res Paediatr Date: 2012-03-16 Impact factor: 2.852
Authors: Paulo F Collett-Solberg; Andréa N Pessoa de Queiroz; Monique Esteves Cardoso; Rafaela Cattan Jusan; Mario Vaisman; Marília M Guimarães Journal: Growth Horm IGF Res Date: 2006-08 Impact factor: 2.372
Authors: G Guarnieri; G Toigo; N Fiotti; B Ciocchi; R Situlin; C Giansante; A Vasile; M Carraro; L Faccini; G Biolo Journal: Kidney Int Suppl Date: 1997-11 Impact factor: 10.545
Authors: Otto Mehls; Anders Lindberg; Richard Nissel; Dieter Haffner; Anita Hokken-Koelega; Michael B Ranke Journal: J Clin Endocrinol Metab Date: 2009-12-11 Impact factor: 5.958
Authors: Izabel C R Beserra; Márcia G Ribeiro; Paulo F Collett-Solberg; Mário Vaisman; Marília M Guimarães Journal: Int J Pediatr Endocrinol Date: 2010-12-27