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Compliance with growth hormone therapy in chronic renal failure and post transplant

L Rees1

  • 1Great Ormond Street Hospital for Children NHS Trust, London, UK.

Insights

Many children with kidney disease miss recombinant human growth hormone (rhGH) injections despite good understanding. Concerns about size and being treated younger than their age were common, but did not correlate with missed doses or growth outcomes.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Patient Adherence Research

Background:

  • Recombinant human growth hormone (rhGH) therapy is crucial for children with renal disease to improve growth.
  • Non-compliance with rhGH treatment can significantly impact therapeutic outcomes.
  • Understanding factors influencing adherence is vital for optimizing treatment in pediatric chronic kidney disease.

Observation:

  • An anonymous questionnaire assessed rhGH non-compliance in 60 children with renal disease.
  • A significant proportion of patients (48%) returned the questionnaires.
  • Psychosocial factors, including body image concerns (69%) and social age perception (83%), were prevalent.

Findings:

  • Despite good comprehension of rhGH purpose and administration, 62% of patients missed injections.
  • No correlation was found between missed rhGH injections and patient understanding, administration difficulties, size concerns, or growth response.
  • Adherence challenges appear multifactorial, extending beyond knowledge and perceived difficulty.

Implications:

  • Psychosocial support may be necessary for children with renal disease undergoing rhGH therapy.
  • Further research into the specific barriers to rhGH adherence is warranted.
  • Addressing patient concerns about size and social age could potentially improve treatment compliance.

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