EFFECTS OF GROWTH-HORMONE ON KIDNEY-FUNCTION IN PEDIATRIC TRANSPLANT RECIPIENTS

Recent evidence suggests that treatment with recombinant human growth hormone (rhGH) after a successful kidney transplant improves the growt h rate of children with short stature. We prospectively investigated e ight children (6 boys, 2 girls), focusing on acute rejection episodes and changes in serum creatinine levels during rhGH treatment. The chil dren (mean age 11.6+/-3.4 years) received rhGH daily (0.04-0.05 mg/kg subcutaneously). Seven patients completed at least 12 months (20+/-8 m onths) of rhGH treatment. Their mean serum creatinine level was 1.3 +/ - 0.7 mg/dl 12 months before, and increased to 3.4+/-4.2 mg/dl after 1 2 months of rhGH treatment, but did not achieve statistical significan ce (P=0.06). Their mean calculated glomerular filtration rate was 58+/ -20 ml/min per 1.73 m(2) 12 months before, and decreased to 38+/-21 ml /min per 1.73 m(2) after 12 months of rhGH treatment, but did not achi eve statistical significance (P=0.08). Of the seven patients, two deve loped acute rejection after 5 and 6 rejection-free years; three lost t heir grafts and returned to dialysis. These preliminary observations d escribe untoward renal events in children receiving rhGH treatment aft er a kidney transplant.