Bone mineral density, bone metabolism and body composition of children with chronic renal failure, with and without growth hormone treatment

• Published in: Clinical endocrinology (Oxford) 1998-11, Vol.49 (5), p.665-672
• Main Authors: Boot, Annemieke M., Nauta, Jeroen, De Jong, Maria C. J. W, Groothoff, Jaap W., Lilien, Marc R., Van Wijk, J. Ans E., Kist-van Holthe, Joana E., S. Hokken-Koelega, Anita C., Pols, Huibert A. P., De Muinck Keizer-Schrama, Sabine M. P. F.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Body Composition - drug effects; Body Height - drug effects; Bone Density - drug effects; Case-Control Studies; Child; Child, Preschool; Drug Therapy, Combination; Female; Hormones. Endocrine system; Human Growth Hormone - therapeutic use; Humans; Hydroxycholecalciferols - therapeutic use; Kidney Failure, Chronic - drug therapy; Kidney Failure, Chronic - physiopathology; Male; Medical sciences; Osteogenesis - drug effects; Pharmacology. Drug treatments
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1046/j.1365-2265.1998.00593.x

OBJECTIVE Osteopenia has been reported in adult patients with chronic renal failure (CRF). Only a few studies have been performed in children. The objective of this study was to evaluate bone mineral density (BMD), bone turnover, body composition in children with CRF and to study the effect of GH on these variables. DESIGN Two groups were identified: patients with growth retardation who received GH (GH‐group) and patients most of whom were not growth retarded who did not receive GH (no‐GH‐group). After an observation period of 6 months, the patients in the GH‐group started GH treatment. Patients were studied every 6 months during 18 months. PATIENTS Thirty‐six prepubertal patients (27 boys and 9 girls), mean age 7.9 years, with CRF participated in the study. The GH‐group consisted of 17 patients of whom 14 completed one year treatment. The no‐GH‐group consisted of 19 patients, of whom 16 were followed for 6 months, 14 for 12 months and 13 for 18 months. MEASUREMENTS Lumbar spine BMD, total body BMD and body composition were assessed by dual energy X‐ray absorptiometry, compared to age‐and sex‐matched reference values of the same population and expressed as standard deviation scores (SDS). BMD of appendicular bone was measured by quantitative microdensitometry (QMD). Blood samples were obtained to assess bone metabolism and growth factors. RESULTS Baseline mean lumbar spine and total body BMD SDS of all patients were not significantly different from normal. Mean lumbar spine and total body BMD SDS did not change significantly in the GH‐group during GH treatment. The change of QMD at the midshaft during the first 6 months of GH treatment was significantly smaller than during the observation period (P