Changes in serum PICP concentrations during therapy with growth hormone in children with chronic renal failure
Maria Sieniawska, Małgorzata Pańczyk-Tomaszewska, Beata Leszczyńska, Maria Roszkowska-Blaim
Med Sci Monit 1998; 4(6): CR960-965
The aim of the study was to evaluate serum PICP level (carboxyterminal propeptide of type I procollagen) during the treatment with recombinant human growth hormone (rhGH) of short-stature children with chronic renal failure (CRF). The work was also an attempt to establish whether PICP level during the first months of therapy had a predictive value concerning faster growth in this group of children. The study included 36 children. Group I consisted of 17 subjects aged 10.3±2.6 years treated with continuous ambulatory peritoneal dialysis (CAPD), group II was made up of 9 children on haemodialysis (HD), aged 12.5±2.1 years, while group III was formed of 10 children with pre-end-stage renal failure (PESRF), aged 10±3.3 years. All the patients received 1.1 u/kg/week subcutaneous rhGH every evening for 12 months. Serum PICP level was determined before starting rhGH treatment as well as in 1, 3, 6, 9 and 12 month of therapy. Patients' growth was measured with stadiometer every 3 months.
Results: Mean growth (DH) after 12 months of treatment was: 7.98±2.04 cm in group I, 7.37±1.9 cm in group II, 8.25±2.47 cm in group III. The highest mean PICP level was observed in 6th month of treatment (423.7±148.7 µg/l), p=0.001 in relation to mean PICP value before the beginning of therapy. There was a stronger positive correlation between PICP concentration in 1st month (r=0.5, p < 0.01) than between PICP level in 3rd and 6th month of treatment and DH after 1 year of rhGH therapy. However, we found low PICP levels in 1st month of therapy in children with satisfactory DH, i.e. over 7cm/year as well as in those with insufficient DH, i. e. below 6 cm/year.
Conclusions: 1. Mean PICP level increases during the first 6 months of treatment with rhGH. 2. PICP concentration in the first month of therapy correlates with growth acceleration in the first year of rhGH administration, but it is of no prognostic value for individual patients.
Keywords: PICP, chronic renal failure, Growth Hormone