Growth hormone treatment of growth failure among children with renal transplants

Jabs, Kathy; Van Dop, Cornelis; Harmon, William E.
October 1993
Kidney International Supplement;Oct1993, Issue 43, pS71
Academic Journal
Eight children with growth failure following renal transplant have been selected for recombinant human growth hormone (rhGH) treatment at Children's Hospital using the following criteria: (1) a functioning allograft for at least one year: (2) height < third percentile; (3) growth velocity < 4 cm/year; (4) growth potential, and (5) low-dose alternate-day glucocorticoid dosing. The children were 7.4 to 17.7 years of age; had received transplants 2.6 to 12.3 years before rhGH treatment; and all had decreased allograft function. The growth velocity of these children increased from 1.7 ± 0.7 to 7.1 ± 2.1 cm/year during the first year of rhGH treatment (0.05 mg/kg s.c. daily). The mean height SD score improved -3.9 ± 1.5 to -3.4 ± 1.3 in the seven children who completed one year of treatment (P < 0.001). There was no change in glucose tolerance during rhGH treatment. The serum creatinine concentration increased in all patients with a concomitant decrease in creatinine clearance. The mean rate of change in the inverse creatinine (l/Cr) increased from -0.005 ± 0.004 dl/mg/month in the two years prior to rhGH treatment to -0.023 ± 0.015 dl/rag/month during rhGH treatment (P < 0.01). The relative risks and benefits of rhGH treatment must be carefully considered for each patient.


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