The Use of Recombinant Human GH (rhGH) in Growth Failure in Children with Various Renal Diseases

Abstract

We evaluated the 1 year effect of recombinant human GH (rhGH), of 0.5 or 1.0 IU/kg/week, on growth in 83 cases of chronic renal failure (CRF) (pre and dialysis), 23 transplanted and 18 children with nephrotic syndrome. In predialysis children height growth velocity (HV) became to be significantly increased from 3.8 at baseline to 7.8 at 6 months and 7.3 cm/year at 1 year with a dose of 0.5 IU (p<0.001). When treated with 1.0 IU, HV was increased from 4.5 to 10.3 at 6 and 8.7 cm/yaer at 1 year (P<0.001). When a comparison was done for the increase in HV, a significant difference was noted between 0.5 IU and 1.0 IU at both 6 and 12 months (P<0.01). In dialyzed children treated with 0.5 IU, HV was significantly increased from 3.5 to 5.6 at 6 months (P<0.01) and 5.4 cm/year at 1 year (P<0.01). In the 1.0 IU group, it was from 3.4 to 8.4 at 6 months (P<0.001) and 8.3 cm/year at 1 year (P<0.01). There was a significant difference in HV between 0.5 and 1.0 IU at both 6 and 12 months (P<0.01). In transplanted children, HV was significantly improved from 5.0 to 7.7 cm/year with 0.5 IU (P<0.05) and from 3.7 to 6.3 cm/year with 1.0 IU (P<0.05) during 1 year of GH treatment but there was no statistical difference between the two groups. Seven out of 23 children showed deterioration of graft function during rhGH treatment due to acute rejection (AR) in all cases. AR was noted in 2 out of 10 children (20%) in the 0.5 IU and 5 out of 13 children (38%) in the 1.0 IU group. In nephrtotic syndrome, HV was increased from 3.3 to 6.5 cm/year at 1 year and to 6.4 cm/year at 2 year (P<0.05). Our results demonstrated that rhGH is effective to stimulating HV in not only CRF but also transplants and nephrotic syndome.