The Effect of Growth Hormone and the Factors Influencing Growth in Pediatric Chronic Peritoneal Dialysis Patients

Kim, Su Jin; Park, Sung Won; Sohn, Young Bae; Jin, Dong Kyu; Paik, Kyung Hoon

Abstract

PURPOSE
Growth failure is a common problem in chronic renal failure(CRF). We studied the effect of growth hormone(GH) treatment and the factors influencing growth on chronic peritoneal dialysis patients.
METHODS
Seventeen patients who were treated with peritoneal dialysis and GH for more than one year were enrolled. Factors influencing growth such as age, height at start of GH treatment, total Kt/Vurea, residual renal Kt/Vurea, hemoglobin, albumin, BUN, creatinine, total CO2, calcium, phosphate and iPTH during GH treatment were compared between the growth group(increase in height-standard deviation score(Ht-SDS) after one year of GH treatment, n=11) and poor growth group(no increase in Ht-SDS after one year of GH treatment, n=6).
RESULTS
The mean age at the start of dialysis was 7.7+/-5.2 years and the mean age at the start of GH treatment was 8.5+/-4.8 years. In the growth group, Ht-SDS at start of GH treatment was smaller(-1.72+/-1.00 vs. -0.77+/-0.88, P=0.048) and residual renal Kt/Vurea was better (1.54+/-0.51 vs. 0.15+/-0.26, P=0.02) than the poor growth group. After three years of GH treatment, Ht-SDS of the growth group was better than the poor growth group.
CONCLUSIONS
GH treatment in children with peritoneal dialysis was more effective on patients who had more severe growth retardation. The reservation of residual renal function was important for improvement of effect of GH treatment. And the growth response during the first year of GH treatment may be predicted as the indicator for long-term response.