[Possible indications for human recombinant growth hormone in adults: current data and future perspectives]

Growth hormone (GH) secretion persists during adulthood with mostly metabolic effects, stimulating lipolysis and protein synthesis. Besides GH-deficient patients, other adult patients might in the future benefit from recombinant GH (rhGH) therapy. These conditions would mainly include: 1. Highly catabolic states in intensive-care patients (conflicting results); 2. Osteoporosis, because of significant, although moderate improvement in bone density; 3. Aging: compensating for age-related GH-deficiency has yielded positive results concerning nutritional status; in the elderly however, the risk of side-effects, above all hypervolemia, should not be overlooked; 4. Uremia, frequently associated with poor nutritional status: preliminary results in hemodialysis patients are certainly encouraging; rhGH coupled with intradialytic parenteral nutrition might be particularly efficient. Treatment of uremic patients before end-stage renal failure seems also to be contemplated since, in spite of hyperfiltration and glomerulosclerosis observed in rats receiving high doses of rhGH, no case of worsened renal failure has ever been reported in pre-dialysis children treated for stunted growth.