RESUMO
BACKGROUND AND OBJECTIVES: Our aim was to evaluate the growth-promoting effect of growth hormone (GH) treatment in infants with chronic renal failure (CRF) and persistent growth retardation despite adequate nutritional and metabolic management. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The study design included randomized, parallel groups in an open, multicenter trial comparing GH (0.33 mg/kg per wk) with nontreatment with GH during 12 months. Sixteen infants who had growth retardation, were aged 12+/-3 months, had CRF (GFRAssuntos
Transtornos do Crescimento/tratamento farmacológico
, Hormônio do Crescimento Humano/uso terapêutico
, Fenômenos Fisiológicos da Nutrição do Lactente
, Falência Renal Crônica/tratamento farmacológico
, Estado Nutricional
, Absorciometria de Fóton
, Ossos do Braço/diagnóstico por imagem
, Ossos do Braço/efeitos dos fármacos
, Ossos do Braço/crescimento & desenvolvimento
, Biomarcadores/sangue
, Estatura/efeitos dos fármacos
, Peso Corporal/efeitos dos fármacos
, Densidade Óssea/efeitos dos fármacos
, Distribuição de Qui-Quadrado
, Ensaio de Imunoadsorção Enzimática
, Feminino
, Taxa de Filtração Glomerular
, Transtornos do Crescimento/sangue
, Transtornos do Crescimento/etiologia
, Transtornos do Crescimento/fisiopatologia
, Hormônio do Crescimento Humano/efeitos adversos
, Humanos
, Lactente
, Falência Renal Crônica/sangue
, Falência Renal Crônica/complicações
, Falência Renal Crônica/fisiopatologia
, Masculino
, Portugal
, Estudos Prospectivos
, Radioimunoensaio
, Espanha
, Ossos do Tarso/diagnóstico por imagem
, Ossos do Tarso/efeitos dos fármacos
, Ossos do Tarso/crescimento & desenvolvimento
, Fatores de Tempo
, Resultado do Tratamento
RESUMO
CONTEXT: GH treatment is effective in children born small for gestational age (SGA); however, its effectiveness and safety in very young SGA children is unknown. OBJECTIVE: The aim was to analyze the outcome of very young SGA children treated with GH and followed for 2 yr. The results after 24 months of treatment, compared with a control group without treatment during 12 months followed by 12 months of treatment, are shown. DESIGN: We performed a multicenter, controlled, randomized, open trial. SETTINGS: The pediatric endocrinology departments of 14 public hospitals in Spain participated in the study. PATIENTS: Seventy-six children, aged 2-5 yr born SGA and without catch-up growth, were studied. INTERVENTION: Children received GH at 0.06 mg/kg.d for 2 yr (group I) or were followed for 12 months with no treatment and then treated for 12 months (group II). MAIN OUTCOME MEASURES: Age, general health status, pubertal stage, bone age, height, weight, biochemical and hormonal analyses, and adverse side effects were determined at biannual check-ups. RESULTS: The mean height sd score gain for chronological age in children treated for 24 months (group I) was 2.10, whereas in those treated only during the last 12 months (group II) was 1.43. In both groups, children under 4 yr of age had the greatest gain in growth velocity. No significant acceleration of bone age or side effects related to treatment was seen. CONCLUSION: Very young SGA children without spontaneous catch-up growth could benefit from GH treatment because growth was accelerated and no negative side effects were observed.