Growth hormone treatment in children with chronic renal failure: a meta-analysis of randomized controlled trials.
OBJECTIVE
To evaluate the benefits and side effects of recombinant human growth hormone (hGH) treatment in children with chronic renal failure.


METHODS
Two reviewers independently assessed relevant randomized controlled trials for methodologic quality, extracted data, and estimated summary treatment effects by use of a random effects model.


RESULTS
Ten randomized controlled trials involving 481 children were identified. Treatment with hGH (28 IU/m(2)/wk) resulted in a significant increase in height standard deviation score at 1 year (4 trials, weighted mean difference [WMD] = 0.77, 95% CI = 0.51 to 1.04), and a significant increase in height velocity at 6 months (2 trials, WMD = 5.7 cm/y, 95% CI 4.4 to 7.0) and 1 year (2 trials, WMD = 4.1 cm/y, 95% CI 2.6 to 5.6), but there was no further increase in height indexes during the second year of administration. Compared with the 14 IU/m(2)/wk group, there was an increase of 1.4 cm/y (0.6 to 2.2) in height velocity in the group treated with 28 IU/m(2)/wk. The frequency of reported side effects of hGH were similar to that of the control group.


CONCLUSIONS
On average, 1 year of treatment with 28 IU/m(2)/wk hGH in children with chronic renal failure results in an increase of 4 cm/y in height velocity above that of untreated control subjects, but there was no demonstrable benefit for longer courses or higher doses of treatment.
Vimalachandra
D
D
Centre for Kidney Research, The Children's Hospital at Westmead, NSW, Australia.
Craig
J C
JC
Cowell
C T
CT
Knight
J F
JF
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001827:Body Height / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy* / Q000209:etiology*; D013006:Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D012737:Sex Factors
D013006:Growth Hormone