Growth hormone treatment enhances bone mineralisation in children with chronic renal failure

Dual energy X-ray absorptiometry of the whole body and the lumbar spine was performed to study bone mineralisation before and after 1 year of recombin ant human growth hormone (rhGH) treatment in ten children with chronic rena l failure. At the start, median age was 7.3 years (range 2.0-8.8 years) and median glomerular filtration rate 15 ml/min per 1.73 m(2) (range 7-41 ml/m in per 1.73 m(2)). Total body mineral content (TBMC), lumbar spine mineral content (LBMC), total body bone mineral density (TBMD) and lumbar spine min eral density (LBMD) improved significantly (P < 0.05) after 1 year of treat ment. Bone mineral data before and after treatment were compared with two g roups of controls, i.e. ten healthy children matched for age and ten health y children matched for height. Patients' TBMC, LBMC, TBMD and LBMD data bef ore treatment were no different from those of height-matched controls; the same was true after 1 year of treatment except for the patients' significan tly better LBMD (P < 0.05). When compared with age-matched controls, patien ts had significantly lower baseline TBMC and LBMC levels before treatment; after treatment LBMC was no longer different. However, there were no differ ences in TBMD or LBMD between patients and age-matched controls at baseline or after rhGH. Conclusion Recombinant human growth hormone treatment for 1 year results in a significant increase in both growth velocity and bone mineralisation. Co mparison with height-matched controls shows a similar bone mineralisation a t baseline and a better bone mineral density after treatment.