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Glomerular filtration rate, blood pressure and microalbuminuria in adults born SGA: A 5‐year longitudinal study after cessation of GH treatment
Author(s) -
Goedegebuure Wesley J.,
Kerkhof Gerthe F.,
HokkenKoelega Anita C. S.
Publication year - 2019
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.14095
Subject(s) - microalbuminuria , medicine , endocrinology , blood pressure , renal function
Background Growth hormone treatment increases glomerular filtration rate (GFR), as serum IGF‐I stimulates the renin‐angiotensin system. Infants born with a low birth weight have a smaller number of nephrons, which cause a lower GFR, a higher blood pressure and a higher albumin‐to‐creatinine ratio in early adulthood. Method A total of 261 young adults born SGA, previously treated with growth hormone (SGA‐GH), were longitudinally followed. Glomerular filtration rate, based on serum creatinine levels, was determined at cessation of GH treatment and at 6 months, 2 years and 5 years thereafter. Glomerular filtration rate, blood pressure and urinary albumin‐to‐creatinine ratio at 5 years after cessation of GH were compared with untreated age‐matched controls (56 untreated short subjects born SGA [SGA‐S], 118 subjects born SGA with spontaneous catch‐up growth [SGA‐CU], 135 subjects born appropriate for gestational age [AGA]). Results Glomerular filtration rate decreased significantly only during the first 6 months after cessation of GH treatment, while remaining well within the normal range (124.6 vs 120.2 mL/min/1.73 m 2 , P < .001). SGA‐GH adults had a similar GFR, blood pressure and urinary albumin‐to‐creatinine ratio as the healthy controls born SGA and AGA. Conclusion In conclusion, our 5 years longitudinal follow‐up study shows a decrease in GFR during 6 months after GH cessation, but thereafter GFR remained stable and within the normal range. Glomerular filtration rate, blood pressure and urinary albumin‐to‐creatinine ratio at 21 years of age were similar in GH‐treated young adults born SGA and untreated controls born SGA or AGA. We conclude that long‐term GH treatment in children born SGA has no unfavourable effects on kidney function in early adulthood. Précis We present a longitudinal study on kidney function in the follow‐up of growth hormone‐treated young adults who were born small for gestational age.