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Growth hormone therapy influences endothelial function in children with renal failure

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Abstract

Endothelial dysfunction, an early step in atherogenesis, is prevalent in children with renal insufficiency. Endothelial dysfunction in growth hormone deficiency is reversed by growth hormone (rhGH) therapy. Renal failure induces growth hormone resistance at the receptor and post-receptor level, which can be overcome by rhGH therapy. This study investigates the influence of rhGH therapy in children with renal failure on flow-mediated dilation (FMD) of the brachial artery, a marker of endothelial function. We studied 8 patients, who were on rhGH for at least 6 months, and 8 healthy children for comparison. FMD of the brachial artery was measured non-invasively as the percentage increase in diameter during post-ischemic hyperemia. Patients were studied at baseline, after 4 weeks interruption of rhGH therapy, and 4 weeks after resumption of therapy. FMD was significantly lower in patients (4.7%) than healthy controls (13.8%) (P=0.01). During the administration of rhGH, FMD was significantly higher (3.9%) than during interruption of the treatment (1.4%) (P=0.04). Our data support the theory that a disturbance in the GH-IGF axis contributes to the endothelial dysfunction of renal failure. Treatment with rhGH not only improves growth but may also favorably influence the risk for atherogenesis.

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Acknowledgements

Part of this study was published in abstract form at the World Congress of Nephrology, Berlin, June 2003.

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Authors and Affiliations

  1. Department of Pediatric Nephrology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, PO Box 85090, 3508 CA Utrecht, The Netherlands

    Marc R. Lilien & Cornelis H. Schröder

  2. Department of Pediatric Nephrology, University Medical Center St. Radboud, Nijmegen, The Netherlands

    Elena N. Levtchenko

  3. Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands

    Hein A. Koomans

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  1. Marc R. Lilien
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  2. Cornelis H. Schröder
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  3. Elena N. Levtchenko
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  4. Hein A. Koomans
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Correspondence to Marc R. Lilien.

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Lilien, M.R., Schröder, C.H., Levtchenko, E.N. et al. Growth hormone therapy influences endothelial function in children with renal failure. Pediatr Nephrol 19, 785–789 (2004). https://doi.org/10.1007/s00467-004-1495-z

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  • DOI: https://doi.org/10.1007/s00467-004-1495-z

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