Growth hormone for children with chronic renal failure and on dialysis.
We studied all children with CRF who received recombinant human growth hormone (rhGH) for more than a year (mean+/-SD duration of therapy 3.7+/-2.5 years) over an 11-year period. There were 32 children. Twenty-one children were conservatively managed, with a mean glomerular filtration rate (GFR) of 24+/-12 mL min(-1)/1.73 m2 at the start of rhGH. Their height standard deviation score improved from -2.5+/-1.4 to -2.1+/-0.7 at 1 year (P=0.3), -2.0+/-0.7 at 2 years (P=0.01), and -1.6+/-0.6 at 3 years (P=0.001). After that there was no improvement. Eleven children were on dialysis, six on haemodialysis (HD) and five on peritoneal (PD). Ht SDS improved from -2.7+/-0.5 to -2.3+/-0.5 at 1 year (P=0.02). Thereafter there was no further improvement. RhGH was stopped because of transplantation in 29 patients at a mean+/-SD age of 12.1+/-4.0 years. Mean Ht SDS was -1.8+/-0.8 at transplant and there was no change over the following 5 years. In conclusion, treatment with rhGH resulted in improvement in Ht SDS in conservatively managed CRF for up to 3.0 years and for 1 year in children on dialysis. Discontinuation of rhGH after transplantation resulted in little change in Ht SDS.
Kari
Jameela A
JA
Pediatrics Department, King AbdulAziz University Hospital, PO Box 80215, 21589, Jeddah, Saudi Arabia. jkari@doctors.org.uk
Rees
Lesley
L
D000293:Adolescent; D001827:Body Height; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D013006:Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007668:Kidney / Q000187:drug effects / Q000254:growth & development*; D007676:Kidney Failure, Chronic / Q000188:drug therapy* / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D010530:Peritoneal Dialysis; D006435:Renal Dialysis
D013006:Growth Hormone