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.