Leczenie rekombinowanym ludzkim hormonem wzrostu niskorosłych dzieci z przewlekłą chorobą nerek w Polsce (1994-2008)

© Borgis - Nowa Pediatria 2/2008, s. 28-34

Helena Ziółkowska¹, *Maria Roszkowska-Blaim¹, Piotr Skrzypczyk¹, Dominika Adamczuk¹, Anna Majcher², Irena Bałasz-Chmielewska³, Katarzyna Zachwieja⁴, Maria Szczepańska⁵, Anna Kałużyńska⁶, Renata Bednorz⁷, Jacek Zachwieja⁸, Grzegorz Siteń⁹, Ryszard Grenda¹⁰, Beata Pacanowska¹¹, Hanna Kipigroch¹², Halina Borzęcka¹³, Walentyna Zoch-Zwierz¹⁴, Ewa Pałuba¹⁵

Streszczenie
Growth retardation in children with chronic kidney disease (CKD) is treated with recombinant human growth hormone (rhGH), in Poland since 1994.
Aim: Aim of the study is to evaluate growth of short-statured children with CKD treated with rhGH.
Material and methods: In years 1994-2008 215 children with CKD aged 1.25-17.8 years (mean age 10.81±3.48 years), 73 girls, 142 boys were treated with rhGH. Out of them 89 children had CKD stages 2-4, 120 children had CKD stage 5, 6 children were after kidney transplantation (KTx). Following data were evaluated: cause of CKD, growth velocity in the first and in the second year of treatment, cause of discontinuation of the treatment and complications. Body height was expressed in cm and SDS (standard deviation score).
Results: The most common cause of CKD in children treated with rhGH were urinary system malformations. At the start of the treatment mean height SDS was -3.03±1.03 in all children, -2.85±1.07 in children with CKD stages 2-4; -3.124±0.99 in children with CKD stage 5; -3.68±0.7 in children after KTx. Mean duration of rhGH treatment was 20.3±17.7 months. Growth velocity in children with CKD stages 2-4 was significantly higher than in children with CKD stage 5 and after KTx (p<0.001). In children with CKD stages 2-4 and with CKD stage 5 growth velocity in the second year of the treatment was significantly lower: in children with CKD stages 2-4 8.86±2.26 and 7.4±1.7 (p<0.005), and in children with CKD stage 5 – 7.81±2.07 and 6.27±2.36 cm/year (p<0.001).
Conclusions: The highest growth velocity in short statured uremic children treated with rhGH was found in predialysis stage in the first year of the treatment. In the second year of the treatment the differences in growth velocity were non-significant.

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