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Published on: January 7, 2016

First-year response to rhGH therapy in children with CKD: a National Cooperative Growth Study Report

John D Mahan1, Bradley A Warady, James Frane

  • 1Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA. John.Mahan@nationwidechildrens.org

Pediatric Nephrology (Berlin, Germany)
|February 24, 2010
PubMed

Insights

Establishing appropriate growth response criteria for recombinant human growth hormone (rhGH) in pediatric chronic kidney disease (CKD) is crucial. This study defines first-year growth response curves for rhGH-treated children with CKD, proposing a threshold for inadequate growth.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Growth Hormone Therapy

Background:

  • The optimal growth response to recombinant human growth hormone (rhGH) in pediatric chronic kidney disease (CKD) patients lacks clear definition.
  • Assessing growth response is vital for optimizing rhGH therapy efficacy in this vulnerable population.

Purpose of the Study:

  • To establish clear benchmarks for the first-year growth response to rhGH in prepubertal children with CKD.
  • To develop age-specific growth curves for monitoring rhGH treatment effectiveness.

Main Methods:

  • Utilized data from Genentech's National Cooperative Growth Study (NCGS) on 270 treatment-naïve, prepubertal children with CKD.
  • Constructed age-specific height velocity (HV) response curves for the first year of rhGH therapy.
  • Combined data from both genders due to lack of significant gender-based differences in HV.

Main Results:

  • Mean height velocity (HV) during the first year of rhGH treatment was consistently higher than pretreatment HV across all ages.
  • The mean - 2SD for HV during rhGH treatment approximated the mean pretreatment HV.
  • Age-specific growth plots illustrating first-year rhGH response were generated.

Conclusions:

  • The developed growth plots provide valuable tools for clinicians to assess the first-year growth response in pediatric CKD patients on rhGH.
  • A proposed threshold for inadequate growth response is a height velocity (HV) below the mean - 1SD.
  • These benchmarks can aid in identifying suboptimal growth responses potentially linked to medical factors or non-compliance.

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