[논문]만성 소아 신질환 환자에서의 성장호르몬 치료 인제의대 부산백병원 소아청소년과

정우영

doi:10.3339/jkspn.2009.13.1.14

[국내논문] 만성 소아 신질환 환자에서의 성장호르몬 치료 인제의대 부산백병원 소아청소년과
Growth Hormone Treatment in Children with Chronic Kidney Disease 원문보기

대한소아신장학회지 = Journal of the Korean society of pediatric nephrology, v.13 no.1, 2009년, pp.14 - 20

Abstract ▼ AI-Helper

Growth retardation is a common consequenc of chronic kidney disease (CKD) in childhood. Many recent clinical and experimental data indicate that growth failure in CKD is mainly due to a relative GH insensitivity and functional IGF-I deficiency. Glucocorticoids also glucocorticoids interfere with the integrity of the somatotropic hormone axis at various levels. Over the past 10 years, recombinant growth hormone (rhGH) has been used to help short children with chronic kidney disease. A GH dosage of 0.35 mg/kg/week (28 IU/$m^2$/week) appears efficient and safe. Some clinical trial data show that final height will be within the normal target height range when GH treatment is continued for many years without remarkable adverse events.

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성능/효과

나머지 20-25%의 IGF들은 다른 IGFBP와 결합하여 이중 복합체를 혈성하며 35 kDa을 형성한다[18]. 전체적으로는 IGF의 97%정도가 복합체를 형성하며 1%정도만이 자유로운 bioactive 형태로 존재한다. 건강한 소아에서는 IGF에 비해 IGFBP가 25%정도 더 많이 존재하는데 반해 만성신부전 환아에서는 IGFBP가 150%, 말기신부전환아에서는 200% 정도 존재하여 결국에는 IGF의 bioavailability를 저하시키게 된다[21].
0 cm 이었다. NAPRTCS가 보고한 심각한 성장장애를 야기시키는 불량한 예후 인자들[3, 4]을 분석한 결과를 살펴보면 6세 이전에 신장이식을 시행한 경우에 있어서 성장 증가는 양호하며, 혈청 크레아티닌 농도가 1 mg/dL 정도 높아질 때마다 Ht SDS는 0.17씩 감소 함으로써 GFR이 성장에 심대한 영향을 미치는 것을 알 수 있다. 또한 스테로이드제제의 복용의 형태(격일요법 vs 매일요법)와 인종적인 요인도 관여한다.

참고문헌 (32)

Seikaly MG, Salhab N, Warady BA, Stablein D. Use of rhGH in children with chronic kidney disease: lessons from NAPRTCS. Pediatr Nephrol 2007;22:1195-204.

상세보기
Lee JW, Kim JS, Kim YY, Kim YH, Yoon YC, Chung WY. Evaluation of effect of renal transplantation on growth in children with chronic renal failure. J Korean Soc Pediatr Nephrol 2006;10:219-27.
Tejani A, Fine R, Alexnder S, Harmon W, Stablein D. Factors predictive of sustained growth in children after renal transplantation. The North American Pediatric Renal Transplant Cooperative Study. J Pediatr 1993;122:397-402.

상세보기
Jabs K, Sullivan EK, Avner ED, Harmon WE, Alternate day steroid dosing improver growth without adversely affecting graft survival or long-teem graft function. A report of the North American Pediatric Renal Transplant Cooperative Study. Transplantation 1996;61:31-6.

상세보기
Furth SL, Hwang W, Yang C, Neu AM, Fivush BA, Powe NR, Growth failure, risk of hospitalization and death for children with end-stage renal disease, Pediatr Nephrol 2002;17:450-5.

상세보기
Goman G, Fivus B, Frankenfield D, Warady B, Watkins S, Brem A, et al. Short stature and growth hormone use in pediatric hemodialysis patients. Pediatr Nephrol 2005;20:1794-800.

상세보기
Hokken-Koelega AC, Saenger P, Cappa M, Greggio N. Unresolved problems concerning optimal therapy of puberty in children with chronic renal disease. J Pediatr Endocrinol Metab 2001;14(Suppl2):945-52.
Seikaly MG, Salhab N, Gipson D, Yiu V, Stablein D. Stature in children with chronic kidney disease: analysis of NAPRTCS databaes. Pediatr Nephrol 2006;21:793-9.

상세보기
Cransberg K, Smits JM, Offner G, Nauta J, Persijin GG. Kidney transplantation without prior dialysis in children: the eurotransplant experience. Am J Transplant 2006;6:1858-64.

상세보기
Schaefer F, Veldhuis JD, Stanhope R, Jones J, Scharer K. Alterations in growth hormone secretion and clearance in peripubertal boys with chronic renal failure and after renal transplantation. Cooperative Study Group of Pubertal Development in Chronic Renal Failure. J Clin Endocrinol Metab 1944;78:1298-306.
Roelfsema V, Clark RG. The growth hormone and insulin-like growth factor axis: its manipulation for the benefit of growth disorders in renal failure. J Am Soc Nephrol 2001;12:1297-306.

상세보기
Oertel PJ, Lichtwald K, Hafner S, Rauh W, Schoenbeg D, Scharer K. Hypothalamo-pituitary-gonadal axis in children with chronic renal failure. Kidney Int 1983;24(Suppl 15):S34-9.
Giusti M, Perfumo F, Verrina E, Cavallero D, Piaggio G, Gusmano R, et al. Biological activity of luteinizing hormone in uraemic children: spontaneous nocturnal secretion and changes after administration of exogenous pulsatile luteinizing hormone-releasing hormone-preliminary observations. Pediatr Nephrol 1991;5:559-65.

상세보기
Schaefer F, Seidel C, Mitchell R, Scharer K, Robertson WR, CSPCRF. Pulsatile immunoreactive and bioactive luteinizing hormone secretion in adolescents with chronic renal failure. Pediatr Nephrol 1991;5:566-71.

상세보기
Mehls O, Ritz E, Hunziker EB, Eggli P, Heinrich U, Zapf J et al. Improvement of

상세보기
Samaan NA, Freeman RM, Growth hormone levels in severe renal failure. Metabolism 1970;19:102-13.

상세보기
Postel-Vinay MC, Tar A, Crosnier H, Broyer M, Rappaport R, Tonshoff B et al. Plasma growth hormone-binding activity is low in uremic children. Pediatr Nephrol 1991;5:545-7.

상세보기
Rabkin R, Sun DF, Chen Y, Tan J, Schaefer F. Growth hormone resistance in uremia, a role for impaired JAK/STAT signaling. Pediatr Nephrol 2005;20:313-8.

상세보기
Kaysen GA. The microinflammatory state in uremia: causes and potential consequences. J Am Soc Nephrol 2001;12:1549-57.

상세보기
Rajaram S, Baylink DJ, Mohan S, Insulin- like growth factor-binding protenisin serum other biological fluids: regulation and functions. Endor Rev 1997;18:801-31.
Blum WF, Ranke MB, Kietzmann K, Tonshoff B, Mehls O, Growth hormone resistance and inhibition of somatomedin activity by excess of insulin-like growth factor binding protein in uraemia. Pediatr Nephrol 1991;5:539-44.

상세보기
Ulinski T, Mohan S, Kiepe D, Blum WF, Wingen AM, Mehls O et al. Serum insulin- like growth factor binding protein (IGFBP)- 4 and IGFBP-5 in children with chronic renal failure: relationship to growth glomerular filtration rate. The European Study Group for Nutritional Treatment of Chronic Renal Failure in Childhood. German Study Group for Growth Hormone Treatment in Chronic Renal Failure. Pediatr Nephrol 2000;14:589-97.

상세보기
Tonshoff B, Kiepe D, Ciarmatori S, Growth Hormone insulin-like growth factor system in children with chronic renal failure. Pediatr Nephrol 2005;20:279-89.

상세보기
Mehls O, Wuhl E, Tonshoff B, Schaefer F, Nissel R, Haffner D. Growth hormone treatment in short children with chronic kidney disease. Acta Paediatrica 2008;97:1159-64.

상세보기
Fine RN, Kohaut E, Brown D, Kuntze J, Attie KM. Long-term treatment of growth retarded children with chronic renal insufficiency, with recombinant human growth hormone. Kidney Int 1996;49:781-5.

상세보기
Haffner D, Schaefer F, Nissel R, Wuhl E, Tonshoff B, Mehls O. Effecr of growth hormone treatment on the adult height of children with chronic renal failure. N Engl J Med 2000;343:923-30.

상세보기
Hertel NT, Holmberg C, Ronnholm KA, Jacobsen BB, Olgaard K, Meeuwisse GW et al. Recombinant human growth hormone treatment, using two dose regimens in children with chronic renal failur-a report on linear growth and adverse effects. J Pediatr Endocrinol Metab 2002;5:577-88.
Fine RN, Kohaut E, Brown D, Perlman AJ. Growth after recombinant human growth hormone treatment in children with chronic renal failure: report of a multicenter randomized double-blind placebo-controlled study. Genetech Cooperative Study Group. J Pediatr 1994;124:374-82.

상세보기
Mahan JD, Warady BA, Consensus Committee. Assessment and treatment of short stature un pediatric patients with chronic kidney disease: a consensus statement. Pediatr Nephrol 2006;21:917-30.

상세보기
Gipson DS, Kausz AT, Striegel JE, Melvin TR, Astrom LJ, Watkins SL, Intraperitoneal administration of recombinant human growth hormone in children with end-stage renal disease. Pediatr Nephrol 2001;16:29-34.

상세보기
Fine RN, Ho M, Tejani A, Blethen S. Adverse events with GH treatment of patients with chronic renal insufficiency and end-stage renal disease. J Pediatr 2003;142:539-45.

상세보기
Rodriguez-Soriano J, Vallo A, Quintela MJ, Malaga S, Loris C. Predictors of final height after renal transplantation during childhood: a single-center study. Nephron 2000;86:266-73.

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