ESPN 51th Annual Meeting

ESPN 2018


 
Auxological and Laboratory Parameters of growth in Egyptian children with CRF on conservative therapy.
MONA ZAHRANE 1 LOUBNA FAWAZ 1 AZZA KAWAGA 2

1- PEDIATRIC DEPARTMENT,CAIRO UNIVERSITY
2- CLINICAL PATHOLOGY DEPARTMENT,CAIRO UNIVERSITY
 
Introduction:

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GH levels in children with CRF  depending on the extent of renal failure  resulting in reduced renal  clearance rate which prolongs  half-life of GH.  the disturbances of the somatotropic hormone axis play  role for growth retardation in children with  (CRF). This led to the concept of GH insensitivity,  The IGFs are unique somatotropic protein hormones.  stored bound to specific IGFBP

 

our aim to study clinical and laboratory parameters of growth  including IGF1 and IGFBP2 as part of the somatotropic hormone axis in children suffering from CRF on conservative therapy

Material and methods:


64 Egyptian children (47 boys and 17 girls) with a mean age of 9.7y  suffering from CRF on conservative therapy and 21 controls were included in the study. Ht, wt and TSF were measured , pubertal staging assessed and followed for  6 months. At the end of the follow up  serum for IGF1 and IGFBP2, renal function, electrolytes,  and blood gases  were measured and an X-ray of the left hand and wrist  to determine  bone age by Tanner and Whitehouse

Results:

 Our study shows that CRF  Children   on conservative therapy have GR with a mean ht of –3.7 SDS, a mean wt of -2.24 SDS. TSF mean was  -1.3 SDS.  the patients had a delay of 2.95y (+/-2.0) in their bone age. Their height retarded more than  bone age with a height age/bone age of 0.8 (+/-0.18). Alkaline phosphatase   is significantly correlated to the height, height age/bone age and to the pH. The mean IGF1SDS  (-0.6 +/-1.8) did not differ from controls ,while the mean IGFBP2SDS (2.4 +/-4.6) was significantly higher  . Height and weight were significantly correlated to IGF1 but not IGFBP2. There is a significant correlation between IGFBP2 level and the GFR .

 

Conclusions:

 imbalance between normal  (IGF-I) and markedly increased IGFBP2  levels plays a pathogenic role for growth retardation in  CRF patients. The lower the GFR the higher the IGFBP2 level. The latters inhibitory action may provide hope for improving growth in  CRF patients by reducing the level of IGFBP2 or displacing IGF1 from it.