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Recombinant human growth hormone treatment in infants with chronic renal failure
Insights
Recombinant human growth hormone (rhGH) significantly improved growth in infants and young children with chronic renal failure. Four out of eight participants achieved normal growth ranges after treatment.
Area of Science:
- Pediatric Nephrology
- Endocrinology
- Growth Disorders
Background:
- Congenital renal disease often leads to poor growth in children.
- Chronic renal failure presents significant challenges to pediatric development and overall health.
Purpose of the Study:
- To evaluate the efficacy and safety of recombinant human growth hormone (rhGH) in improving growth in pediatric patients with chronic renal failure.
- To assess the impact of rhGH on growth parameters and relevant biochemical markers in this patient population.
Main Methods:
- A one-year trial involving eight infants and young children with chronic renal failure.
- Treatment with rhGH was administered, with regular monitoring of height, growth velocity, glomerular filtration rate (GFR), and biochemical markers.
- Participants had a mean chronological age of 1.9 years and a mean GFR of 17 ml/min/1.73 m2 at study entry.
Main Results:
- rhGH treatment led to a significant increase in height standard deviation score (SDS) from -3.3 to -2.2 (p = 0.0002).
- Height velocity SDS also significantly improved, rising from -1.3 to 1.1 (p = 0.006).
- Four children achieved growth within the normal range; no significant adverse events or changes in GFR, lipids, or glucose were observed.
Conclusions:
- rhGH is an effective treatment for improving growth in children with chronic renal failure.
- The treatment demonstrated a favorable safety profile, with no serious adverse events reported.
- rhGH offers a promising therapeutic option for addressing growth failure in pediatric patients with kidney disease.
Abstract:
Poor growth is a particular problem for children with congenital renal disease. A one year trial of the use of recombinant human growth hormone (rhGH) in eight infants and young children with chronic renal failure is reported here. At entry bone age was less than 2 years, mean (range) chronological age 1.9 (1.3-2.7) years, and glomerular filtration rate (GFR) was 17 (9-42) ml/min/1.73 m2. Height standard deviation score (SDS) was -3.3 (-4.6 to -2.0) and height velocity SDS was -1.3 (-3.1 to 0.7). One child was withdrawn when he received a renal transplant after 9.5 months. Two children required dialysis, but remained in the trial. Treatment with rhGH resulted in an increase in height SDS to -2.2 (-4.2 to -0.9), p = 0.0002, and height velocity SDS to 1.1 (-0.7 to 2.6), p = 0.006. There was no change in GFR and no serious adverse events. There was no effect on plasma lipids, calcium, phosphate, intact parathyroid hormone, or glucose. Alkaline phosphatase rose significantly. Thus rhGH improved growth in eight infants with chronic renal failure, with four children entering the normal range.