The effect of recombinant human growth hormone treatment on bone ...

Nephrol Dial Transplant (1998) 13: 1529–1534

Nephrology Dialysis Transplantation

Preliminary Report

The effect of recombinant human growth hormone treatment on bone and mineral metabolism in haemodialysis patients Jeppe Gram1, Tony Bill Hansen1, Per Bruno Jensen2, Jan Hardam Christensen3, Søren Ladefoged4 and Fritz Bangsgaard Pedersen2 1Department of Endocrinology and 2Department of Nephrology, Odense University Hospital, Odense, 3Department of Internal Medicine, Fredericia Hospital, Fredericia and 4Department of Nephrology, Hvidovre Hospital, Copenhagen, Denmark

Abstract Background. Uraemia and chronical haemodialysis are associated with an abnormal growth hormone (GH )–insulin-like growth factor (IGF ) axis which may contribute to malnutrition and renal bone disease. Short-term studies have shown a beneficial effect of treatment with recombinant human growth hormone (rhGH ) on nutritional status in patients on haemodialysis. In the present study, we evaluated the effect of rhGH on bone and mineral metabolism. Methods. Twenty chronic malnourished patients on haemodialysis took part in a double-blind, placebo controlled trial with subcutaneous injections of rhGH (4 IU/m2/day) or placebo for 6 months. Results. During rhGH treatment, serum IGF-1 increased 264±52% (mean±SEM ) (P2.0 mmol/l ).

Methods DXA scans to assess bone mineral content [BMC (g)] and density [BMD (g/cm2)] were performed at different anatomical regions [whole body and hip (total and femoral neck] using a Hologic QDR 2000/W scanner. All scans were performed in single beam mode. The in vivo precision (CV ) of BMD measurements of whole body and femur is 1.6 and 0.6% respectively. Serum IGF-I was measured after extraction with HCl/ ethanol in an immunofluorometric sandwich assay with two monoclonal antibodies using the Delphia principle and an AutoDelphia reader ( Wallac, Turku, Finland ). The detection

J. Gram et al.

limit was 2.5 ng/l. Intra- and interassay CV were