EVALUATION OF CLINICAL AND LABORATORY PARAMETERS DURING 2 YEARS OF GROWTH-HORMONE TREATMENT IN PREPUBERTAL CHILDREN WITH CHRONIC-RENAL-FAILURE

Twelve prepubertal children with chronic renal failure (CRF) were trea ted with human growth hormone (GH) (1.2 IU/kg/week) for 2 years. High doses of GH clearly increased growth velocity, from 3.8 +/- 1.3 to 9.6 +/- 1.5 (P = 0.0001) and 6.9 +/- 0.8 cm/year (P = 0.0001) after the 1 st and 2nd year of treatment, respectively, leading to a mean height g ain of 1.4 SD. During the Ist year of treatment the height increment, expressed in SDS, correlated negatively with chronological age (P = 0. 003). Basal insulin-like growth factor 1 (IGF 1) levels were normal or elevated (7/12 patients) and correlated positively with the overnight integrated GH concentration (r = 0.68, P < 0.001). Basal insulin-like growth factor binding protein 3 (IGF-BP3) levels were elevated in 8/1 2 patients. GH induced a significant increase in IGF 1 and IGF-BP3 lev els; IGF 1 peaked after 6 months (when growth velocity was optimal) an d IGF-BP3 peaked after 12 months. The mean glomerular filtration rate, measured by inulin clearance and corrected for body surface area, fel l after the Ist year of treatment, and significantly so at the end of the 2nd year (P = 0.02). Conclusion Early initiation of GH therapy dur ing CRF may prevent severe growth retardation and allow these children to attain normal height before dialysis and transplantation.