5 YEARS EXPERIENCE WITH RECOMBINANT HUMAN GROWTH-HORMONE TREATMENT OFCHILDREN WITH CHRONIC-RENAL-FAILURE

11 males, aged 2.5-16.3 years (6.8 +/- 4.1) with growth retardation (S tandard Deviation Score - SDS > -2.00) consequent to chronic renal fai lure (CRF) received recombinant human growth hormone (rhGH) for 18 to 60 mo (40.9 +/- 15.4). Growth velocity (GV) increased from 5.4 +/- 2.2 for the year prior to rhGH to 8.9 +/- 1.6 (p=0.00001), 7.4 +/- 1.7 (p <0.03), 7.6 +/- 1.6 (p<0.006), 6.5 +/- 1.0 (p<0.05) and 7.5 +/- 1.3 (p =NS) cm/yr following 12, 24, 36, 48 and 60 mo respectively of treatmen t. The mean SDS for height decreased from -3.21 at baseline to -0.85 a t 60 mo (p=0.0004); 7 of 8 pts treated for >36 mo had a SDS more posit ive than -2.00; 3 reached the 50th percentile on the growth curve. In 2 patients the dosage was doubled to achieve the increase in GV; in on e patient it took 5 yrs to reach a SDS more positive than -2.00. A sig nificant increase in weight gain and mid-arm muscle circumference over baseline values were indicative of the anabolic effect of rhGH. The m ean increase in bone age was similar to the increase in chronologic ag e; the delta bone age - delta height age was not significant indicatin g no loss of growth potential following rhGH. Although 3 patients requ ired the initiation of dialysis following rhGH treatment, the mean cal culated creatinine clearance did not decrease significantly. No signif icant adverse effects were noted. These data indicate that long-term r hGH treatment is effective in improving the GV of children with CRF an d facilitating catch-up growth without loss of growth potential.