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Growth hormone treatment in short children with chronic kidney disease

O Mehls1, E Wühl, B Tönshoff

  • 1Division of Pediatric Nephrology, University Hospital of Pediatric and Adolescent Medicine, Heidelberg, Germany. Otto.Mehls@med.uni-heidelberg.de

Acta Paediatrica (Oslo, Norway : 1992)
|July 16, 2008
PubMed

Insights

Growth hormone (GH) therapy effectively improves growth in children with chronic kidney disease (CKD). Early treatment initiation with preserved kidney function maximizes benefits for final height.

Area of Science:

  • Pediatrics
  • Nephrology
  • Endocrinology

Background:

  • Growth hormone (GH) has been utilized for nearly 17 years to address impaired growth in pediatric chronic kidney disease (CKD).
  • Studies demonstrate GH's efficacy in enhancing growth velocity and adult height in these patients.
  • Factors like age, dialysis duration, and corticosteroid use influence growth response.

Purpose of the Study:

  • To evaluate the effectiveness and safety of growth hormone (GH) treatment in children with chronic kidney disease (CKD).
  • To identify factors influencing growth response to GH therapy in pediatric CKD patients.

Main Methods:

  • Analysis of controlled and open-label studies on GH treatment in children with CKD.
  • Correlation analysis of growth response with patient age, height, dialysis time, GH dose, treatment duration, and primary renal disease.
  • Assessment of adverse events in GH-treated CKD children compared to non-CKD controls.

Main Results:

  • GH treatment significantly improved final height by 0.5-1.7 standard deviation scores (SDS) compared to controls.
  • Growth response is negatively associated with early age/height at start and dialysis duration.
  • GH effectively counteracts growth failure induced by corticosteroid treatment in renal transplant recipients.

Conclusions:

  • Growth hormone (GH) treatment is safe and highly effective for improving growth and final height in short children across all stages of CKD.
  • Optimal outcomes are achieved with early treatment initiation, preserved renal function, and continuation until final height attainment.
Abstract

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