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Effectiveness of growth hormone on growth and final height in paediatric chronic kidney disease

Melanie K Aldridge1,2,3, Peter Trnka4,5, Anna Francis4,5

  • 1Child and Adolescent Renal Service, Queensland Children's Hospital, Brisbane, Australia. melanie.aldridge@health.qld.gov.au.

Pediatric Nephrology (Berlin, Germany)
|September 7, 2021
PubMed

Insights

Recombinant human growth hormone (rhGH) effectively improves height in children with chronic kidney disease (CKD) before kidney replacement therapy (KRT). Its impact on final height is less pronounced in children undergoing KRT.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Growth Hormone Therapy

Background:

  • Chronic kidney disease (CKD) and kidney failure significantly impact growth in children.
  • Recombinant human growth hormone (rhGH) is a potential therapeutic option for growth promotion in these pediatric populations.
  • Understanding the effectiveness of rhGH across different stages of kidney disease is crucial for treatment optimization.

Purpose of the Study:

  • To evaluate the effectiveness of rhGH on growth and final height (FH) in Australian children with CKD and kidney failure.
  • To compare growth outcomes in children treated with rhGH before and after commencing kidney replacement therapy (KRT).
  • To analyze the impact of rhGH on height standard deviation scores (Ht-SDS) in pediatric CKD patients.

Main Methods:

  • Data linkage between the ANZDATA and OzGrow registries for Australian children with CKD and kidney failure treated with rhGH.
  • Inclusion of a CKD cohort treated with rhGH prior to KRT and a KRT cohort with and without rhGH treatment.
  • Calculation of Ht-SDS and definition of final height based on age- and sex-specific criteria.

Main Results:

  • Significant growth improvement (ΔHt-SDS = +0.80) was observed in the rhGH-treated CKD group prior to KRT (p < 0.001).
  • Growth also significantly improved in the rhGH-treated KRT group (ΔHt-SDS = +0.38, p < 0.001).
  • Within the KRT cohort, rhGH treatment showed a marginal, non-significant improvement in catch-up growth (ΔHt-SDS = +0.05) compared to untreated patients (ΔHt-SDS = -0.03, p = 0.49).

Conclusions:

  • rhGH is confirmed as effective in enhancing height for children with CKD before initiating KRT.
  • The impact of rhGH on growth and final height is variable and appears less significant once children have commenced KRT.
  • Further research may be needed to optimize rhGH therapy in pediatric kidney failure patients undergoing KRT.
Abstract

Keywords:
Chronic kidney diseaseGrowthGrowth hormonePaediatric

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