GROWTH-HORMONE TREATMENT IN GROWTH-RETARDED ADOLESCENTS AFTER RENAL-TRANSPLANT

Growth failure is a psychosocial problem for many patients who have un dergone renal transplantation. 18 adolescents (mean age 15.6, range 11 .3-19.5) with severe growth retardation after renal transplantation we re treated with biosynthetic growth hormone (GH) for 2 years. All rece ived prednisone, administered daily or on alternate days, with azathio prine and/or cyclosporin A. 16 were blindly assigned to one of two GH doses (4 vs 8 IU per m(2) per day). Growth, bone maturation, renal gra ft function, plasma insulinlike growth factors, serum binding proteins , and other biochemical parameters were checked regularly. Glomerular filtration rate and effective renal plasma flow were tested with I-125 -Thalamate and I-131-Hippuran. Data on growth and glomerular filtratio n rate during GH treatment were also compared with those of matched no n-GH-treated controls. Mean (standard deviation) increment in height a fter 2 yea rs of GH was 15.7 (5.1) cm, significantly greater (p < 0.00 01) than in matched controls, 5.8 (3.4) cm. Results were similar for t he two GH dosage groups. Bone maturation was not accelerated. Glomerul ar filtration rate and effective renal plasma flow did not change sign ificantly. The incidence of a > 25% reduction in glomerular filtration rate over 2 years was not significantly higher in GH-treated patients than in non-GH-treated controls (39% vs 32%, p = 0.97). Although a fe w patients had deterioration of graft function, we could not find a re lation with GH treatment. Our results show that sustained improvement of height can be achieved with GH in severely growth-retarded adolesce nts after renal transplantation.