Effect of growth hormone treatment on the adult height of children with chronic renal failure.

Background: Growth hormone treatment stimulates growth in short children wi th chronic renal failure. However, the extent to which this therapy increas es final adult height is not known. Methods: We followed 38 initially prepubertal children with chronic renal f ailure treated with growth hormone for a mean of 5.3 years until they reach ed their final adult height. The mean (+/-SD) age at the start of treatment was 10.4+/-2.2 years, the mean bone age was 7.1+/-2.3 years, and the mean height was 3.1+/-1.2 SD below normal. Fifty matched children with chronic r enal failure who were not treated with growth hormone served as controls. Results: The children treated with growth hormone had sustained catch-up gr owth, whereas the control children had progressive growth failure. The mean final height of the growth hormone-treated children was 165 cm for boys an d 156 cm for girls. The mean final adult height of the growth hormone-treat ed children was 1.6+/-1.2 SD below normal, which was 1.4 SD above their sta ndardized height at base line (P<0.001). In contrast, the final height of t he untreated children (2.1+/-1.2 SD below normal) was 0.6 SD below their st andardized height at base line (P<0.001). Although prepubertal bone maturat ion was accelerated in growth hormone-treated children, treatment was not a ssociated with a shortening of the pubertal growth spurt. The total height gain was positively associated with the initial target-height deficit and t he duration of growth hormone therapy and was negatively associated with th e percentage of the observation period spent receiving dialysis treatment. Conclusions: Long-term growth hormone treatment of children with chronic re nal failure induces persistent catch-up growth, and the majority of patient s achieve normal adult height. (N Engl J Med 2000;343:923-30.) (C)2000, Mas sachusetts Medical Society.