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Published on: January 7, 2016

Short stature and growth hormone use in pediatric hemodialysis patients

Gregory Gorman1, Barbara Fivush, Diane Frankenfield

  • 1Johns Hopkins University School of Medicine, Baltimore, MD 21287-2535, USA. ggorman1@jhmi.edu

Pediatric Nephrology (Berlin, Germany)
|September 1, 2005
PubMed

Insights

Pediatric end-stage renal disease (ESRD) patients often experience short stature. Recombinant human growth hormone (rhGH) is underutilized in these children, with white race, longer dialysis duration, and lower BMI predicting its use.

Area of Science:

  • Pediatric Nephrology
  • Growth Hormone Therapy
  • Renal Osteodystrophy

Background:

  • End-stage renal disease (ESRD) in children is associated with growth retardation, negatively impacting outcomes.
  • Recombinant human growth hormone (rhGH) is a potential therapeutic intervention to improve growth velocity and final adult height in pediatric ESRD patients.

Purpose of the Study:

  • To identify clinical predictors of short stature (height standard deviation score [Ht SDS] <-1.88) in pediatric hemodialysis patients.
  • To determine predictors of rhGH use among short stature pediatric hemodialysis patients.

Main Methods:

  • Utilized data from the 2002 Centers for Medicare & Medicaid Services (CMS) Clinical Performances Measures (CPM) ESRD Project.
  • Included all US in-center hemodialysis patients aged <18 years.
  • Employed multivariate logistic regression to determine odds ratios (OR) for short stature and rhGH use.

Main Results:

  • 41% of 651 pediatric hemodialysis patients had short stature.
  • Short stature was predicted by congenital/urologic ESRD causes and increasing years on dialysis.
  • Among short stature patients, 37% received rhGH, predicted by white race, longer dialysis duration, and BMI <16.6 kg/m(2).

Conclusions:

  • A significant proportion of pediatric hemodialysis patients suffer from short stature.
  • The majority of these short-stature patients are not receiving rhGH therapy.
  • Predictors for rhGH use include white race, longer dialysis duration, and lower BMI, highlighting potential disparities in treatment access.

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