EFFECT OF GROWTH-HORMONE ON URINE CALCIUM AND SERUM VITAMIN-D METABOLITES IN RENAL-FAILURE

Growth hormone (GH) causes a modest increase in urine calcium excretio n in normal adults, but uremic rats given both GH and calcitriol devel oped hypercalciuria. Ten short prepubertal children with renal insuffi ciency treated with recombinant human GH (rhGH) had urine calcium to c reatinine (Ca/Cr) ratios and serum vitamin D metabolite concentrations monitored prospectively for up to 24 months. Six were also treated wi th calcitriol and two with other vitamin D preparations. Mean urine Ca /Cr ratios or mean serum concentrations of 1,25-dihydroxy vitamin D, 2 4,25-dihydroxy vitamin D, and 25-hydroxy vitamin D did not change sign ificantly during treatment with rhGH. The risk for rhGH-induced hyperc alciuria is small in children with renal insufficiency, even when trea ted concomitantly with a vitamin D preparation.