만성 복막투석 환자에서 성장호르몬 치료의 효과와 성장에 영향을 주는 요인에 대한 연구 |
김수진, 박성원, 손영배, 진동규, 백경훈 |
1성균관대학교 의과대학 소아과학교실 2성균관대학교 의과대학 소아과학교실 3성균관대학교 의과대학 소아과학교실 4성균관대학교 의과대학 소아과학교실 5성균관대학교 의과대학 소아과학교실 |
The Effect of Growth Hormone and the Factors Influencing Growth in Pediatric Chronic Peritoneal Dialysis Patients |
Su-Jin Kim, Sung-Won Park, Young-Bae Sohn, Dong-Kyu Jin, Kyung-Hoon Paik |
1Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Medical Center 2Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Medical Center 3Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Medical Center 4Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Medical Center 5Department of Pediatrics, Sungkyunkwan University School of Medicine, Samsung Medical Center |
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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. CONCLUSIONS: 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. |
Key words:
Chronic renal failure | Growth hormone | Peritoneal dialysis | Residual renal function | Growth hormone treatment |
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