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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