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Accelerated growth after recombinant human growth hormone treatment of children with chronic renal failure
V H Koch1, B M Lippe, P A Nelson
1Department of Pediatrics, University of California, Los Angeles 90024.
Insights
Recombinant human growth hormone treatment significantly improved growth velocity in boys with chronic renal failure. This therapy offers a promising solution for growth retardation in pediatric kidney disease patients.
Area of Science:
- Pediatric Nephrology
- Endocrinology
- Growth Hormone Therapy
Background:
- Children with chronic renal failure (CRF) often experience growth retardation.
- Congenital renal diseases are a common cause of CRF in children.
- Standard growth metrics like height standard deviation score (SDS) are typically below normal in these patients.
Purpose of the Study:
- To evaluate the efficacy of recombinant human growth hormone (rhGH) in improving growth velocity in prepubertal children with CRF.
- To assess the impact of rhGH on height SDS and bone age advancement.
- To monitor safety and metabolic parameters during rhGH treatment.
Main Methods:
- A cohort of five boys with CRF (mean age 4.6 years) received rhGH (0.125 mg/kg) three times weekly for one year.
- Pre- and post-treatment growth velocity and height SDS were measured.
- Bone age and routine laboratory tests, including glucose tolerance tests, were assessed.
Main Results:
- Mean annual growth velocity increased from 4.9 cm/yr to 8.9 cm/yr after rhGH treatment.
- Mean height SDS improved from -2.98 to -2.36.
- Bone age advancement was consistent with the treatment duration, and no significant adverse metabolic changes were observed.
Conclusions:
- rhGH therapy can significantly accelerate growth velocity in children suffering from growth retardation due to CRF.
- Exogenous growth hormone is a viable treatment option for improving linear growth in this patient population.
- Further studies are warranted to confirm long-term efficacy and safety.
Abstract:
We studied the effect of recombinant human growth hormone treatment on five boys, aged 4.6 +/- 1.8 years, who had chronic renal failure secondary to congenital renal diseases (mean creatinine clearance (+/- SD): 18.3 +/- 6.3 ml/min/1.73 m2 (0.32 +/- 0.11 ml/sec/1.73 m2]. Patients received 0.125 mg/kg of growth hormone three times per week for 1 year. Before beginning treatment, the children had a mean annual growth velocity of 4.9 +/- 1.4 cm/yr (range 3.0 to 6.3 cm/yr), with a mean standard deviation score for a height of -2.98 +/- 0.73 (range -2.16 to -3.59). At the end of therapy, the mean growth velocity had increased to 8.9 +/- 1.2 cm/yr (range 7.5 to 10.7 cm/yr), and the mean height standard deviation score improved to -2.36 +/- 0.83 (range -1.15 to -3.18). Bone age advancement was consistent with the period of growth. Routine laboratory determinations, including results of glucose tolerance testing, did not vary significantly from pretreatment levels. These preliminary data indicate that growth-retarded children with chronic renal failure can respond to exogenous growth hormone therapy with a marked acceleration in growth velocity.