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Title of Journal: Pediatr Nephrol

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Abbravation: Pediatric Nephrology

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Springer-Verlag

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DOI

10.1002/ajpa.1114

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1432-198X

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Longitudinal growth in chronic hypokalemic disorde

Authors: Helena GilPeña Natalia Mejia Oscar AlvarezGarcia Vanessa Loredo Fernando Santos
Publish Date: 2009/11/10
Volume: 25, Issue: 4, Pages: 733-737
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Abstract

Growth retardation remains a major complication in children with primary tubular disorders despite adequate supplemental treatment with electrolytes water and bicarbonate Chronic hypokalemia characteristic of some tubulopathies impairs growth by mechanisms that are not well known Association with growth hormone deficiency has been reported in patients with Bartter’s or Gitelman’s syndrome Tissuespecific alterations of growth hormone and insulinlike growth factor I axis have been described in experimental models of potassium depletion Hypokalemic rats gain less body length and weight than pairfed normokalemic animals and by contrast develop renal hypertrophy These rats have low circulating concentrations of insulinlike growth factor I depressed messenger ribonucleic acid mRNA levels of this peptide in the tibial growth plate and they are resistant to the longitudinal growthpromoting effects of exogenous growth hormone The reason for this resistance remains to be defined No alterations in the intracellular signaling for growth hormone have been found in the liver of hypokalemic rats However treatment with high doses of growth hormone is unable to normalize hypertrophy of the epiphyseal cartilage chondrocytes which are severely disturbed in potassium depletion and likely play an important role in the pathogenia of growth impairment in this conditionThis work was supported by grant FIS 06/1730 and Fundación Nutrición y Crecimiento It was completed during the sabbatical stay of N Mejia from Hospital Universitario Fundación Santa Fé Bogotá Colombia Presented in part at the 8th International Symposium on Growth and Nutrition in Children with Chronic Renal Disease Oviedo Spain 28–30 May 2009

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