GROWTH IN RENAL-FAILURE - A LONGITUDINAL-STUDY OF EMOTIONAL AND BEHAVIORAL-CHANGES DURING TRIALS OF GROWTH-HORMONE TREATMENT

Growth and psychological functioning were studied in 30 patients with renal failure over a two year period following the offer of growth hor mone treatment for significant short stature. Parents' concerns about growth decreased significantly during the study. Twenty eight parents (93%) accepted growth hormone treatment; most (74%) were satisfied wit h it and would opt for it again (89%). The views of these parents were unrelated to growth outcome in their child. This suggests that the po sitive responses were related more to the effort to improve growth tha n to any objective treatment success. In contrast children's reduction in concern about growth, satisfaction with treatment (36%), and decis ion to opt for growth hormone again (50%) were all significantly relat ed to improvement in growth. Parents' reports of noncompliance increas ed significantly from 41% at 1 year to 91% at 2 years in the group as a whole. No significant changes were identified in maternal mental dis tress and no additional costs to the psychological health of the child ren seem to have resulted from the introduction of growth hormone trea tment. A group of children was identified who accepted treatment but h ad continued poor growth. These appeared to be at particular risk of b oth physical problems and associated or consequent psychological diffi culties.