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Growth hormone therapy in chronic renal failure induces catch-up of head circumference
1Department of Pediatrics, University Hospital Gasthuisberg, Leuven, Belgium.
Insights
Recombinant human growth hormone (rhGH) therapy significantly improves head circumference in children with chronic renal failure (CRF). This growth hormone treatment also enhances height but has a lesser effect on head size compared to height.
Area of Science:
- Pediatrics
- Nephrology
- Endocrinology
Background:
- Chronic renal failure (CRF) can impact growth and development in prepubertal children.
- Growth hormone deficiency is a potential complication of CRF.
- Recombinant human growth hormone (rhGH) is used to treat growth issues in children.
Purpose of the Study:
- To evaluate the effect of rhGH on head circumference growth in prepubertal patients with CRF.
- To assess changes in height, weight, and body mass index (BMI) alongside head circumference during rhGH treatment.
Main Methods:
- A study involving 21 prepubertal patients with CRF, treated with rhGH for 12-24 months.
- Measurements of head circumference, height, weight, and BMI were taken before and during rhGH therapy.
- Patients were categorized based on age (under/over 5 years) to analyze differences in head circumference changes.
Main Results:
- Mean height standard deviation score (SDS) significantly increased from -2.29 to -1.07 after 2 years of rhGH therapy.
- Mean head circumference SDS improved significantly from -2.04 to -1.45 after 1 year.
- Head circumference growth showed age-dependent responses, with younger children exhibiting faster significant increases.
Conclusions:
- rhGH therapy significantly improves head circumference SDS in prepubertal children with CRF.
- While rhGH enhances head circumference, the effect is less pronounced than that observed for height SDS.
- The findings support the use of rhGH for improving growth parameters in pediatric CRF patients.
Abstract:
Growth of head circumference was studied along with height, weight, and body mass index (BMI) in 21 prepubertal patients with chronic renal failure (CRF) before and during recombinant human growth hormone (rhGH) treatment. CRF was present from birth in 15 patients, in the 6 others it was acquired and existing for at least 1 year. Five patients were on chronic dialysis, and 16 children were on conservative treatment with a median glomerular filtration rate of 17 ml/min per 1.73 m2 at the start of rhGH therapy. rhGH was administered for 12 months in all patients, for 18 months in 19, and for 24 months in 12 patients. Mean height standard deviation score (SDS) increased significantly from -2.29 to -1.31 after 1 year and to -1.07 after 2 years. Mean BMI SDS was within the normal range throughout. Mean head circumference SDS improved significantly from -2.04 to -1.45 after 1 year and remained stable thereafter. Changes in head circumference differed between patients under 5 years and those over 5 years. In the former, the increase in head circumference SDS was already significant after 6 months of therapy, in the latter, significance was reached only after 1 year. It can be concluded that rhGH in CRF patients significantly improves head circumference SDS, albeit not to the same extent as height SDS.
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