Growth hormone for children with chronic renal failure and on dialysis

We studied all children with CRF who received recombinant human growth hormone ( rhGH) for more than a year ( mean+/-SD duration of therapy 3.7+/-2.5 years) over an 11-year period. There were 32 children. Twenty-one children were conservatively managed, with a mean glomerular filtration rate (GFR) of 24+/-12 mL min(-1)/ 1.73 m(2) at the start of rhGH. Their height standard deviation score improved from - 2.5+/-1.4 to - 2.1+/-0.7 at 1 year (P=0.3), - 2.0+/-0.7 at 2 years (P=0.01), and - 1.6+/-0.6 at 3 years (P=0.001). After that there was no improvement. Eleven children were on dialysis, six on haemodialysis (HD) and five on peritoneal (PD). Ht SDS improved from - 2.7+/-0.5 to - 2.3+/-0.5 at 1 year (P=0.02). Thereafter there was no further improvement. RhGH was stopped because of transplantation in 29 patients at a mean+/-SD age of 12.1+/-4.0 years. Mean Ht SDS was - 1.8+/-0.8 at transplant and there was no change over the following 5 years. In conclusion, treatment with rhGH resulted in improvement in Ht SDS in conservatively managed CRF for up to 3.0 years and for 1 year in children on dialysis. Discontinuation of rhGH after transplantation resulted in little change in Ht SDS.