Bone density and body composition in chronic renal failure: effects of growth hormone treatment

Metabolic bone disease and growth retardation are common complications of c hronic renal failure (CRF). We evaluated bone mineral density (BMD), bone m etabolism, body composition and growth in children with CRF, and the effect of growth hormone treatment (GHRx) on these variables. Thirty-three prepub ertal patients with CRF were enrolled including 18 children with growth ret ardation, who were treated with growth hormone for 2 years. Every 6 months, BMD of lumbar spine and total body, and body composition were measured by dual-energy X-ray absorptiometry. Biochemical parameters of bone turnover w ere assessed. Mean BMD of children with CRF did not differ from normal. Dur ing GHRx, BMD and bone mineral apparent density of lumbar spine and height SDS increased, whereas BMD of total body did not change. Lean body mass inc reased in the GH group. Alkaline phosphatase increased significantly in the GH group only. The other biochemical parameters of bone turnover increased in both groups, none of them correlated with the changes in BMD. No seriou s adverse effects of GHRx were reported. In conclusion, BMD of children wit h CRF did not differ from healthy children. Adequate treatment with alpha - calcidiol or the short duration of renal failure may have attributed to the absence of osteopenia in our patients. BMD of the axial skeleton and growt h improved with GHRx.