Growth hormone treatment improves final height and nutritional status of children with chronic kidney disease and growth deceleration

Abstract

Purpose

Growth retardation is a common complication of chronic kidney disease (CKD) in children. Treatment with recombinant human growth hormone (rhGH) has been used to help short children with CKD to attain a height more in keeping with their age group, but the scientific evidence regarding the effect of rhGH on final height is scarce.

Methods

Final heights of children with CKD receiving rhGH treatment (cases) were compared with final heights of a matched cohort of children with CKD that did not receive rhGH therapy (controls).

Results

Sixty-eight rhGH-treated cases (44 boys) were compared with 92 untreated controls (60 boys). Mean duration of rhGH therapy was 4.2 ± 0.9 years; rhGH dose was 0.3 ± 0.07 mg/kg/week. Height SDS at baseline was lower in rhGH-treated patients than in controls (−2.00 ± 1.02 versus −0.96 ± 1.11, p < 0.001). Baseline height SDS was significantly lower than target height SDS in both groups. Height SDS significantly improved from baseline to final height attainment in rhGH-treated patients, while it slightly decreased in controls (mean SDS variation 0.69 ± 1.05 in rhGH-treated cases versus −0.15 ± 1.2 in controls). Final height SDS was −1.25 ± 1.06 in rhGH-treated cases and −1.06 ± 1.17 in controls (p = 0.29). Target adjusted final height SDS was −0.91 ± 1.03 in rhGH-treated cases and −0.61 ± 1.17 in controls (p = 0.1).

Conclusions

Long-term rhGH therapy is able to reduce the linear growth deceleration of children with CKD, and ultimately to improve their final height, reducing the difference with target height.

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