Post graft development of short children treated with growth hormone before kidney graft

Sixteen prepubertal patients with chronic renal failure (CRF) were given da ily recombinant human growth hormone (rhGH) treatment (1.2 IU/kg per week) for 2.6+/-1.6 years until kidney transplant. Therapy was then discontinued and the patients followed for a further 3.5+/-1.4 years. During treatment, mean height increased from -3.0+/-0.9 standard deviation score (SDS) to -1. 9+/-1.4 SDS (P<0.001) at the time of transplantation, corresponding to a me an height gain of +1.2+/-0.9 SDS. After discontinuation of rhGH therapy, pr epubertal children continued a partial catch-up growth with a height gain o f +0.5+/-0.8 SDS for the follow-up period. Conversely, negative changes of height were observed in pubertal transplanted children: -0.5+/-0.4 SDS in p atients grafted at early stages of puberty (P2-P3) and -0.15+/-0.9 SDS in p atients grafted at late stages of puberty (P4-P5). These data confirmed the benefit of rhGH therapy in CRF patients. Nevertheless, only early initiati on of rhGH treatment led some of these patients to their target height at t ransplantation, thus preserving their potential growth. Reinitiation of rhG H therapy after transplantation should be considered in order to complete c atch-up growth to target height in prepubertal children.