title: "Low-dose" growth hormone therapy during peritoneal dialysis or following renal transplantation.
abstract: The minimal effective dose of growth hormone (GH) to promote growth in children on dialysis or following renal transplantation remains unsettled. In order to study the issue, "low-dose" GH was administered to children with end-stage renal disease (ESRD) receiving chronic automated peritoneal dialysis (APD, n = 6, 4 males, 2 females) or following renal transplantation (T, n = 9, 8 males, 1 female). No APD patient was GH deficient, while 1 T patient (no. 2) had data consistent with GH deficiency, although he was obese (body mass index = 34 kg/m2). The mean dose of GH after 6 and 12 months of treatment was 0.16 +/- 0.02 and 0.22 +/- 0.07 versus 0.16 +/- 0.03 and 0.27 +/- 0.21 mg/kg per week for APD and T patients, respectively. When analyzing all patients, there were no significant differences before or after 6 and 12 months of GH therapy within or between the two groups, in terms of height velocity, bone age, renal function (in the T group) and height Z-scores (Z-Ht). However, the height velocity Z-score (Z-HV) increased significantly at 6 and 12 months compared with baseline in the APD patients only (P < 0.05). When the 2 T patients with the most impaired renal function were excluded from the analysis, Z-HV also increased significantly in the T patients after 12 months of GH (P < 0.02). We conclude that following "low-dose" GH therapy, children with ESRD treated with APD or T have similar increases in HV, allowing maintenance of Z-Ht but not "catch-up" growth.
authors.affiliation: Department of Pediatrics, University of Missouri Kansas City School of Medicine, Children's Mercy Hospital, Kansas City 64108, USA.
authors.forename: I D
authors.initials: ID
authors.lastname: Schwartz
authors.forename: B A
authors.initials: BA
authors.lastname: Warady
authors.forename: C L
authors.initials: CL
authors.lastname: Buchanan
authors.forename: L
authors.initials: L
authors.lastname: Reed
authors.forename: L M
authors.initials: LM
authors.lastname: Hussey
authors.forename: C P
authors.initials: CP
authors.lastname: Howard
authors.forename: S
authors.initials: S
authors.lastname: Hellerstein
authors.forename: J A
authors.initials: JA
authors.lastname: Grunt
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006130:Growth Disorders / Q000209:etiology / Q000628:therapy*; D013006:Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D010530:Peritoneal Dialysis
chemical_list: D013006:Growth Hormone