"Low-dose" growth hormone therapy during peritoneal dialysis or following renal transplantation

Area of Science:

• Pediatric Nephrology
• Endocrinology
• Growth Hormone Therapy

Background:

• The optimal growth hormone (GH) dosage for children with end-stage renal disease (ESRD) undergoing dialysis or renal transplantation is not well-established.
• Children with ESRD often experience growth failure, necessitating therapeutic interventions.

Purpose of the Study:

• To investigate the efficacy of low-dose GH therapy in promoting growth in pediatric patients with ESRD on automated peritoneal dialysis (APD) or post-renal transplantation (T).
• To compare growth parameters, including height velocity and Z-scores, between APD and T patient groups receiving GH treatment.

Main Methods:

• A cohort of children with ESRD receiving chronic APD (n=6) or following renal transplantation (T, n=9) were administered low-dose GH.
• Growth parameters such as height velocity (HV), bone age, height Z-scores (Z-Ht), and height velocity Z-scores (Z-HV) were assessed at baseline, 6 months, and 12 months.
• Renal function was monitored in the T group, and specific patient subgroups were analyzed to account for confounding factors.

Main Results:

• No significant differences in Z-Ht were observed within or between APD and T groups after 6 or 12 months of GH therapy.
• Height velocity Z-scores (Z-HV) significantly increased at 6 and 12 months in APD patients compared to baseline.
• A significant increase in Z-HV was observed in T patients after 12 months of GH treatment when excluding those with the most impaired renal function.

Conclusions:

• Low-dose GH therapy in children with ESRD on APD or following transplantation leads to comparable increases in height velocity.
• This therapeutic approach helps maintain existing height Z-scores but does not facilitate significant catch-up growth in these pediatric populations.
• Further research may be needed to optimize GH dosing strategies for maximizing growth potential in ESRD patients.