RECOMBINANT HUMAN GROWTH-HORMONE (RHGH) T REATMENT OF CHILDREN WITH CHRONIC-RENAL-FAILURE OR FOLLOWING RENAL-TRANSPLANTATION

Background. - Administration of recombinant human growth hormone (rhGH ) to children with chronic renal failure (CRF), on conservative treatm ent or kidney transplanted, may induce acceleration of growth. We repo rt our experience of the first 3 years of treatment in such children. Patients and methods. - Eight children with CRF on conservative treatm ent and six kidney transplanted children were included in a European m ulticentric trial. All children were given rhGH, 30 Ul/m(2) body surfa ce area/week, as daily subcutaneous injections, for 12-36 months. Resu lts. - The mean growth velocity in children with CRF increased from 3. 8 +/- 0.4 cm/yr before treatment to 9.0 +/- 0.4 (P < 0.001), 6.5 +/- 0 .3 (P < 0.002) and 5.4 +/- 0.5 cm/yr, after 12, 24 and 36 months of tr eatment, respectively. The height gain after 2 years of treat ment was 1.2 SD (P < 0.001) with bone age advancement not greater than the inc rease in chronological age. There was a significant decrease in the in ulin clearance after 1 year of treatment. In transplanted children, th e mean height gain was less important increasing from 3.2 +/- 0.4 cm/y r before treatment to 6.2 +/- 0.6 cm/yr after 12 months of treatment ( P < 0.001). There was no significant decrease in the mean inulin clear ance, but two patients experienced rejection crisis. Conclusions. - A short-term rhGH treatment may improve growth velocity of CRF or transp lanted children. The possible role of GH on decrease in glomerular fil tration in CRF and on incidence of acute kidney rejection after transp lantation remains to be evaluated in a large cohort of patients.