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Journal of the Korean Society of Pediatric Nephrology 2006;10(2): 142-151.
장기간의 스테로이드 치료를 받고 있는 신병증 환아에서 Recombinant Human Growth Hormone의 효과
김세진, 김선경, 김성도, 조병수
1경희대학교 의과대학 소아과학교실
2경희대학교 의과대학 소아과학교실
3경희대학교 의과대학 동서신장병연구소
4경희대학교 의과대학 동서신장병연구소
The Effect of Recombinant Human Growth Hormone on Growth in Children with Nephropathy Receiving Long-term Steroid Therapy
Se-Jin Kim, Sun-Kyoung Kim, Sung-Do Kim, Byoung-Soo Cho
1Department of Pediatrics, College of Medicine, Kyung-Hee University
2Department of Pediatrics, College of Medicine, Kyung-Hee University
3East-West Kidney Disease Research Institute, College of Medicine, Kyung-Hee University
4East-West Kidney Disease Research Institute, College of Medicine, Kyung-Hee University
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ABSTRACT
Purpose : Growth retardation is one of the serious problems in children with nephropathy requiring long-term steroid therapy. We observed the efficacy and safety of recombinant human growth hormone(rhGH) on the growth in children with long-term steroid therapy.
Methods : We studied 60 children(male 47, female 13) with nephropathy who received rhGH(1 U/kg/week) for more than 0.5 years($1.39{pm}1.12$). Their mean age was 11.0 years($11.17{pm}2.62$). They received steroid therapy from January 1987 through July 2005, and the mean duration of steroid therapy was $4.32{pm}2.97$ years. Among the patients, there were 32 nephrotic syndrome, 9 IgA nephropathy, 4 mesangial proliferative glomerulonephritis, 4 focal segmental glomerulosclerosis, 2 Henoch $Schddot{o}nlein$ nephritis, 2 Alport syndrome and 7 other cases. Data were gathered on the growth parameters, such as growth velocity, height standard deviation score(SDS), IGF-1, IGFBP-3, bone mass density(BMD) and general chemistry changes.
Results : Height velocity increased significantly with rhGH therapy from $3.29{pm}1.95$ to $8.66{pm}3.75$(cm/yr) and height SDS decreased from $-0.72{pm}0.93$ to $-1.04{pm}0.86$ at one year after steroid therapy but increased to $-0.55{pm}0.96$ at one year after rhGH administration(P<0.05). BMD improved from $0.71{pm}0.14$ to $0.79{pm}0.15g/cm^2$(P<0.05). IGF-1 increased from $445.09{pm}138.01$ to $506.62{pm}181.31ng/mL$(P<0.05). IGFBP-3 decreased from $4073.75{pm}700.78$ to $3933.61{pm}789.25ug/L$ numerically, but there was no statistically significant difference(P=0.533).
Conclusion : The administration of rhGH in the short stature patients who received long-term steroid therapy showed improvement in growth parameters such as SDS, growth velocity, and BMD without significant side-effects or changes in the biochemical parameters.
Key words: rhGH | Growth retardation | Nephrotic syndrome
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