Growth hormone therapy in chronic renal failure induces catch-up of head circumference

Growth of head circumference was studied along with height, weight, and bod y mass index (BMI) in 21 prepubertal patients with chronic renal failure (C RF) before and during recombinant human growth hormone (rhGH) treatment. CR F was present from birth in 15 patients, in the 6 others it was acquired an d existing for at least 1 year. Five patients were on chronic dialysis, and 16 children were on conservative treatment with a median glomerular filtra tion rate of 17 ml/main per 1.73 m(2) at the start of rhGH therapy. rhGH wa s administered for 12 months in all patients; for 18 months in 19, and for 24 months in 12 patients. Mean height standard deviation score (SDS) increa sed significantly from -2.29 to -1.31 after 1 year and to -1.07 after 2 yea rs. Mean BMI SDS was within the normal range throughout. Mean head circumfe rence SDS improved significantly from -2.04 to -1.45 after 1 year and remai ned stable thereafter. Changes in head circumference differed between patie nts under 5 years and those over 5 years. In the former, the increase in he ad circumference SDS was already significant after 6 months of therapy, in the latter, significance was reached only after 1 year. It can be concluded that rhGH in CRF patients significantly improves head circumference SDS, a lbeit not to the same extent as height SDS.