The Effect of Recombinant Human Growth Hormone on the Growth in the Children with Chronic Renal Failure

Yang, Sei Won; Choi, Yong

Abstract

PURPOSE
We observed the effect of three year-administration of recombinant human growth hormone(rhGH) on the growth in the children with chronic renal failure(CRF).
METHODS
Five prepubertal children(three boys and two girls) with CRF, who had been managed by conservative methods, were given rhGH(1 U/kg/week) for three years. Growth parameters, such as growth velocity, height standard deviation score(SDS), and predicted final adult height, obtained by TW, BP, and RWT methods, were monitored during rhGH treatment periods.
RESULTS
1) The GV increased significantly with rhGH therapy from 3.8+/-1.2cm/year to 8.4+/-1.3cm/year(1st year), 7.1+/-3.8cm/year(2nd year), and 6.3+/-0.9cm/year(3rd year) and GV tended to decrease over years with rhGH therapy(Fig. 1, p<0.05). 2) The height SDS increased signficantly with rhGH from -3.2+/-1.3 to -2.6+/-1.1(1st year), -2.2+/-1.2(2nd year) and -2.2+/-1.5(3rd year) and height SDS also tended to decrease over years with rhGH therapy(Fig. 2, p=0.05). 3) FAHs, obtained by TW and BP methods, seemed to increase at 1st and 2nd year of rhGH therapy(p=0.05, and p<0.05, respectively), but did not show any significant increase at 3rd year of therapy, compared to those of pretreatment. FAH, obtained by RWT method, did not show any significant change with rhGH therapy. 4) There was no significant correlation between the GV and chronological or bone age at the start of rhGH therapy, but there was a significant correlation between the chronological age and the height SDS at 2nd year(p<0.05, r=-0.93) and at 3rd year (p<0.05, r=-0.97) of rhGH therapy(Fig. 4), but there was no relationship between the height SDS and bone age. 5) There had been no noticeable side effect, especially deterioration of renal function.
CONCLUSIONS
The long-term administration of rhGH in the children with CRF can result in the improvement of growth parameters, such as growth velocity, height SDS, and predicted final adult height, but these parameters seems to be weakened over years with rhGH therapy, which could be overcome by the increase of rhGH dose. It seems to be better to start rhGH treatment at an early stage of CRF and early chronological age to achieve better growth.