FACTORS PREDICTIVE OF THE SHORT-TERM AND LONG-TERM EFFICACY OF GROWTH-HORMONE TREATMENT IN PREPUBERTAL CHILDREN WITH CHRONIC-RENAL-FAILURE

To evaluate the growth-stimulating effects of short- and long-term tre atment with recombinant human growth hormone (rhGH) in growth-retarded children with chronic renal failure (CRF), 103 prepubertal children w ith CRF on conservative treatment (n = 74) or dialysis (n = 29) were t reated with rhGH for up to 5 yr. rhGH treatment persistently increased standardized height (+1.6 SD scores) and predicted adult height (+7.7 cm, Tanner method) during the first 3 treatment years (P < 0.001 vers us baseline), followed by percentile parallel growth during continued treatment. Both standardized height and predicted adult height were si gnificantly more increased in conservatively treated than in dialyzed children (P < 0.001). Age, GFR, target height, and prestudy growth rat e were identified as independent predictors of the response to rhGH tr eatment during the first and second treatment year. GFR and target hei ght were positively correlated with the change in height SD score and the change in absolute or age-standardized height velocity. Age affect ed the growth response depending on which outcome measure was used: Al though the first-year change in height SD score was inversely correlat ed with age, the change in absolute height velocity was independent of age, and the change in standardized height velocity was positively co rrelated with age. The growth response during the first treatment year positively predicted the long-term response. In conclusion, the short - and long-term growth response to rhGH treatment in prepubertal growt h-retarded children with CRF is significantly affected by age, GFR, ta rget height, and the pretreatment growth rate. Therefore, rhGH should be preferably started at a young age, and early in the course of CRF.