title: Growth hormone treatment of growth failure among children with renal transplants.
abstract: Eight children with growth failure following renal transplant have been selected for recombinant human growth hormone (rhGH) treatment at Children's Hospital using the following criteria: (1) a functioning allograft for at least one year; (2) height < third percentile; (3) growth velocity < 4 cm/year; (4) growth potential; and (5) low-dose alternate-day glucocorticoid dosing. The children were 7.4 to 17.7 years of age; had received transplants 2.6 to 12.3 years before rhGH treatment; and all had decreased allograft function. The growth velocity of these children increased from 1.7 +/- 0.7 to 7.1 +/- 2.1 cm/year during the first year of rhGH treatment (0.05 mg/kg s.c. daily). The mean height SD score improved -3.9 +/- 1.5 to -3.4 +/- 1.3 in the seven children who completed one year of treatment (P < 0.001). There was no change in glucose tolerance during rhGH treatment. The serum creatinine concentration increased in all patients with a concomitant decrease in creatinine clearance. The mean rate of change in the inverse creatinine (1/Cr) increased from -0.005 +/- 0.004 dl/mg/month in the two years prior to rhGH treatment to -0.023 +/- 0.015 dl/mg/month during rhGH treatment (P < 0.01). The relative risks and benefits of rhGH treatment must be carefully considered for each patient.
authors.affiliation: Division of Nephrology, Children's Hospital, Boston.
authors.forename: K
authors.initials: K
authors.lastname: Jabs
authors.forename: C
authors.initials: C
authors.lastname: Van Dop
authors.forename: W E
authors.initials: WE
authors.lastname: Harmon
mesh_terms: D000293:Adolescent; D002648:Child; D002657:Child Development; D003404:Creatinine / Q000097:blood; D005947:Glucose / Q000378:metabolism; D006130:Growth Disorders / Q000188:drug therapy* / Q000209:etiology*; D013006:Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D016030:Kidney Transplantation; D009994:Osmolar Concentration; D011183:Postoperative Complications; D011994:Recombinant Proteins
chemical_list: D011994:Recombinant Proteins; D013006:Growth Hormone; D003404:Creatinine; D005947:Glucose