scholarly journals Factors Predicting the Near-Final Height in Growth Hormone-Treated Children and Adolescents with Chronic Kidney Disease

2008 ◽  
Vol 93 (4) ◽  
pp. 1359-1365 ◽  
Author(s):  
Richard Nissel ◽  
Anders Lindberg ◽  
Otto Mehls ◽  
Dieter Haffner
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Conservative Treatment ◽  
Outcome Measures ◽  
Growth Response ◽  
Adult Height ◽  
Final Height ◽  
Delayed Puberty ◽  
Gh Therapy ◽  
Gh Treatment

Abstract Context: GH therapy is an accepted measure to increase adult height in young prepubertal patients suffering from growth failure related to chronic kidney disease (CKD). The impact of GH therapy on final height (FH) in CKD patients of pubertal age is unclear. Objective: This study set out to analyze near-FH in a cohort of GH-treated CKD patients. Design, Settings, and Patients: Of 240 evaluable patients in the Pfizer International Growth Database (KIGS) with CKD, 39% were prepubertal and 61% were pubertal at baseline; 45% were on conservative treatment for CKD, 28% were on dialysis, and 27% were in the period after renal transplantation. Main Outcome Measures: Near-FH, relation to pubertal stage, and factors predictive of growth response were the main outcome measures. Results: Mean height sd scores increased continuously during GH treatment until near-FH by 1.2 and 1.6 in boys and girls, respectively. Mean near-FH differed significantly from prepubertal patients showing severely delayed puberty (−3.6), late pubertal patients (−2.9), early pubertal patients (−2.2), and prepubertal patients with normal onset of puberty (−2.0). The initial degree of stunting, degree of bone age retardation, duration of GH therapy, time spent on conservative treatment/dialysis, pubertal delay (>2 sd), gender, and age at start of GH treatment were significant predictors of growth response to GH therapy, explaining between 33 and 61% of the overall variability. Conclusions: Long-term GH therapy of CKD patients in prepubertal and pubertal age results in an increased adult height, but response is diminished in patients on dialysis and/or with severely delayed puberty.

scholarly journals Final Adult Height after Growth Hormone Treatment in Patients with Turner Syndrome

2019 ◽  
Vol 91 (6) ◽  
pp. 373-379 ◽  
Author(s):  
Jung Min Ahn ◽  
Jung Hwan Suh ◽  
Ah Reum Kwon ◽  
Hyun Wook Chae ◽  
Ho-Seong Kim
Keyword(s):  
Growth Hormone ◽  
Turner Syndrome ◽  
Adult Height ◽  
Final Height ◽  
Early Age ◽  
Gh Therapy ◽  
Gh Treatment ◽  
Height Range ◽  
Final Adult Height ◽  
Height Gain

Aims: This study aimed to evaluate final adult height (AH) after recombinant human growth hormone (GH) treatment of girls with Turner syndrome (TS) and to elucidate the predicting factors for their growth response. Methods: We enrolled 73 patients with TS who underwent GH treatment and reached AH and 14 patients who did not undergo treatment. To assess the effectiveness of GH therapy, we evaluated final AH, height gain over the predicted AH, and height gain over the projected AH. In addition, to analyze the factors affecting final AH, we studied correlations between final AH (or height SDS, height gain) and treatment variables. Results: GH therapy was started at a mean age of 8.87 ± 3.73 years, and the treatment duration was 6.47 ± 3.02 years. The patients in the treated group reached a final AH of 152.03 ± 4.66 cm (final AH SDS for the general population: –1.93 ± 1.03) with a gain over projected AH at the start of treatment of 12.21 ± 4.33 cm. The untreated control subjects had a final AH of 143.57 ± 4.06 cm with a gain over projected AH at the first visit of 3.89 ± 3.80 cm. Final AH and AH SDS were positively correlated to height SDS at the start of treatment. Thirty-five patients out of the 73 GH-treated patients (47.9%) attained to a normal range of height for Korean girls. The patients having attained to a normal height range after GH treatment had shown a higher height SDS at the start of GH treatment, a higher mid-parental height SDS, and a younger age at initiation of estrogen. Conclusions: Our findings demonstrate that GH treatment at an early age is effective in improving the final height SDS and height SDS gain in TS patients. Therefore, GH administration at an early age is important for final height gain.

scholarly journals Long-term GH treatment improves adult height in children with Noonan syndrome with and without mutations in protein tyrosine phosphatase, non-receptor-type 11

2008 ◽  
Vol 159 (3) ◽  
pp. 203-208 ◽  
Author(s):  
C Noordam ◽  
P G M Peer ◽  
I Francois ◽  
J De Schepper ◽  
I van den Burgt ◽  
...  
Keyword(s):  
Protein Tyrosine Phosphatase ◽  
Noonan Syndrome ◽  
Adult Height ◽  
Final Height ◽  
Tyrosine Phosphatase ◽  
Receptor Type ◽  
Gh Therapy ◽  
Gh Treatment ◽  
Protein Tyrosine

ContextNoonan syndrome (NS) is characterized by short stature, typical facial dysmorphology and congenital heart defects. Short-term effect of GH therapy in NS is beneficial, reports on the effect on adult height are scarce.ObjectiveTo determine the effect of long-term GH therapy in children with NS.DesignTwenty-nine children with NS were treated with GH until final height was reached.SettingHospital endocrinology departments.PatientsChildren with the clinical diagnosis of NS, with mean age at the start of therapy of 11.0 years, 22 out of 27 tested children had a mutation in the protein tyrosine phosphatase, non-receptor-type 11 gene (PTPN11 gene).InterventionsGH was administered subcutaneously at 0.05 mg/kg per day until growth velocity was 1 cm/6 months.Main outcome measureLinear growth (height) was measured at 3-month intervals in the first year and at 6-month intervals thereafter until final height.ResultsAt the start of treatment, median height SDS (H-SDS) was −2.8 (−4.1 to −1.8) and 0.0 (−1.4 to +1.2), based on national and Noonan standards respectively. GH therapy lasted for 3.0–10.3 years (median, 6.4), producing mean gains in H-SDS of +1.3 (+0.2 to +2.7) and +1.3 (−0.6 to +2.4), based on national and Noonan standards respectively. In 22 children with a mutation in PTPN11 mean gain in H-SDS for National standards was +1.3, not different from the mean gain in the five children without a mutation in PTPN11+1.3 (P=0.98).ConclusionLong-term GH treatment in NS leads to attainment of adult height within the normal range in most patients.

scholarly journals Terms of specialized nursing language for chronic renal patients undergoing conservative treatment

2020 ◽  
Vol 73 (suppl 6) ◽  
Author(s):  
Harlon França de Menezes ◽  
Alessandra Conceição Leite Funchal Camacho ◽  
Silvia Maria de Sá Basílio Lins ◽  
Tatiane da Silva Campos ◽  
Fillipe Rangel Lima ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Conservative Treatment ◽  
Content Validity ◽  
Nursing Practice ◽  
Methodological Study ◽  
Validity Index ◽  
Content Validity Index ◽  
A Value ◽  
Nursing Language

ABSTRACT Objectives: to validate the terms of the specialized nursing language used in the care of people with chronic kidney disease undergoing conservative treatment identified in the literature by mapping them with terms of the International Classification for Nursing Practice, version 2019, and representing them by means of a mandala. Methods: descriptive, documentary and methodological study. The terms were collected in 53 scientific articles, standardized and mapped with the terminology. The validation was performed by six nurses through a focus group. The Content Validity Index was used and terms with a value ≥ 0.80 were validated. Results: the normalization resulted in 957 relevant terms, of which 499 were constant and 458 not included in the terminology. Terms were validated when Content Validity Index was between 0.86 and 1.0. Conclusions: the study allowed the validation of terms that will contribute to unify the professional language of nursing in the care of people with chronic kidney disease.

scholarly journals Progression of Aortic Calcification in Stage 4–5 Chronic Kidney Disease Patients Transitioning to Dialysis and Transplantation

2021 ◽  
pp. 1-8
Author(s):  
Roosa Lankinen ◽  
Markus Hakamäki ◽  
Tapio Hellman ◽  
Niina S. Koivuviita ◽  
Kaj Metsärinne ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Conservative Treatment ◽  
Left Ventricular ◽  
Waiting List ◽  
Aortic Calcification ◽  
Transplant Recipients ◽  
Treatment Groups ◽  
In The Beginning

<b><i>Background and Aims:</i></b> Abdominal aortic calcification (AAC) is common in chronic kidney disease (CKD) patients and associated with increased mortality. Comparative data on the AAC score progression in CKD patients transitioning from conservative treatment to different modalities of renal replacement therapy (RRT) are lacking and were examined. <b><i>Methods:</i></b> 150 study patients underwent lateral lumbar radiograph to study AAC in the beginning of the study before commencing RRT (AAC1) and at 3 years of follow-up (AAC2). We examined the associations between repeated laboratory tests taken every 3 months, echocardiographic and clinical variables and AAC increment per year (ΔAAC), and the association between ΔAAC and outcomes during follow-up. <b><i>Results:</i></b> At the time of AAC2 measurement, 39 patients were on hemodialysis, 39 on peritoneal dialysis, 39 had a transplant, and 33 were on conservative treatment. Median AAC1 was 4.8 (0.5–9.0) and median AAC2 8.0 (1.5–12.0) (<i>p</i> &#x3c; 0.0001). ΔAAC was similar across the treatment groups (<i>p</i> = 0.19). ΔAAC was independently associated with mean left ventricular mass index (LVMI) (log LVMI: β = 0.97, <i>p</i> = 0.02) and mean phosphorus through follow-up (log phosphorus: β = 1.19, <i>p</i> = 0.02) in the multivariable model. Time to transplantation was associated with ΔAAC in transplant recipients (per month on the waiting list: β = 0.04, <i>p</i> = 0.001). ΔAAC was associated with mortality (HR 1.427, 95% confidence interval 1.044–1.950, <i>p</i> = 0.03). <b><i>Conclusion:</i></b> AAC progresses rapidly in patients with CKD, and ΔAAC is similar across the CKD treatment groups including transplant recipients. The increment rate is associated with mortality and in transplant recipients with the time on the transplant waiting list.

scholarly journals Depressive symptoms in chronic kidney disease: A comparison between patients on dialysis versus conservative treatment

2017 ◽  
Vol 14 (4) ◽  
pp. 153-159 ◽  
Author(s):  
Geraldo Bezerra da Silva Junior ◽  
Antonio Marcelo de Oliveira Barbosa ◽  
Guilherme Pinheiro Ferreira da Silva ◽  
Liliane Nunes da Silva ◽  
Gabriela Rocha Lima ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Depressive Symptoms ◽  
Kidney Disease ◽  
Conservative Treatment
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