Journal Article

Vitamin D metabolite requirements in dialysed children receiving recombinant human growth hormone

Małgorzata Pańczyk-Tomaszewska, Helena Ziółkowska, Andrzej Dębiński and Maria Sieniawska

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 15, issue 3, pages 375-378
Published in print March 2000 | ISSN: 0931-0509
Published online March 2000 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/15.3.375
Vitamin D metabolite requirements in dialysed children receiving recombinant human growth hormone

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Background. The aim of the study was to assess the requirement of active vitamin D in dialysed children during treatment with recombinant human growth hormone (rhGH).

Methods. Twenty-six children (aged 5–15 years) were treated with rhGH for 6 months. The serum concentration of parathyroid hormone (PTH), alkaline phosphatase (AP), and calcium and phosphorus were measured in two groups of patients studied in the years 1994–1995 (group I) and 1995–1998 (group II) respectively. Group I received a constant dose of alfacalcidol that was sufficient to keep PTH below 200 pg/ml before rhGH treatment began. The serum PTH level was checked every 3 months. Alfacalcidol was administered to group II according to serum PTH levels checked on a monthly basis.

Results. In group I the PTH level increased after 3 and 6 months of rhGH treatment from mean level 73±60; 155±156 and 344±249 pg/ml respectively; P<0.05. AP activity increased after 6 months of treatment from 206±99 to 325±124 U/l respectively; P<0.01. The calcium level decreased from baseline after 3 months of treatment from 2.36±0.21 to 2.17±0.12 mmol/l respectively; P<0.05. In group II AP activity increased after 3 and 6 months of treatment from 272±169 to 332±192 and 404.9±219.8 U/l respectively; P<0.01. The mean level of phosphorus decreased after 6 months from 2.15±0.28 to 1.70±0.39 mmol/l respectively; P<0.01. In group II the mean dose of alfacalcidol increased by 60.9%.

Conclusions. In children with end-stage renal failure, higher doses of vitamin D are needed during rhGH treatment. During rhGH treatment, frequent control of serum PTH level is necessary.

Keywords: alfacalcidol; alkaline phosphatase; children; end-stage renal failure; growth hormone; growth retardation; parathyroid hormone

Journal Article.  2370 words. 

Subjects: Nephrology

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