Accelerated growth and improved nutritional status after recombinant human growth hormone (rhGH) therapy in uremic children.

The effect of recombinant human growth hormone (Norditropin, Novonordisk) was studied in 6 children (4 boys and 2 girls) on maintenance hemodialysis, age 13.8 (range 11-17) years. The recombinant human growth hormone (rhGH) was given in a dose of 4 IU/m2/day s.c. Height velocity was followed 6 months before therapy (washout period) and 6 and 12 months later. Growth was estimated by use of Holtain stadiometer in the same conditions and by the same investigator. Nutritional status was assessed by anthropometric measurements including triceps skinfold thickness (TST), midarm muscle circumference (MAMC), and lean body mass (LBM), as well as serum albumin concentration. The mean height velocity increased from 1.67 +/- 0.98, before therapy to 3.33 +/- 1.25 and 6.70 +/- 0.9 cm 6 and 12 months after therapy, respectively (p < 0.001). Body weight also increased during the treatment period from 29.45 +/- 5.24 to 30.96 +/- 6.4 and 31.68 +/- 6.42 kg (p < 0.02) and so did body surface area from 1.01 +/- 0.12 to 1.07 +/- 0.13 and 1.15 +/- 0.1 m2 (p < 0.001). LBM increased from 26.8 +/- 5.4 to 29.85 +/- 6.42 and 31.1 +/- 7.01 kg 6 and 12 months after therapy (p < 0.001). There was a decrease in TST from 7.35 +/- 1.8 to 6.8 +/- 2.18 and 6.8 +/- 2.4 mm (p < 0.3, NS), and an increase in MAMC from 15.15 +/- 2.42 to 16.1 +/- 2.4 and 17.63 +/- 2.6 cm 6 and 12 months after therapy (p < 0.001). Serum albumin concentration increased from 33.5 +/- 1.22 to 36.0 +/- 2.4 and 38.66 +/- 1.03 g/L (p < 0.001). Nutrition parameters confirmed the beneficial effect of rhGH therapy. The authors recommend rhGH therapy in uremic children with growth retardation as well as in any case of malnutrition in these patients.