Linear growth of children with nephrotic syndrome: effect of alkylating agents.

Growth velocity measurements were assessed in 12 children with steroid responsive but frequent relapsing or dependent nephrotic syndrome prior to and following treatment with either cyclophosphamide or chlorambucil and alternate day prednisone. Patients averaged 6 +/- 3 years (mean +/- SD) of age at the time of treatment. All of the patients underwent renal biopsy prior to treatment; 5 of the 12 showed mesangial proliferation; and in 10 of the 12, IgM deposits were seen within the mesangium of the glomerulus. Growth rates before treatment with the alkylating agent were 4.3 +/- 1.3 cm/y increasing to 8.7 +/- 2.5 cm/y (P less than .001) after therapy despite the relapses that occurred in 5 of the patients in the year following treatment. Short-term side effects of the treatment were minimal. The significant increase in growth associated with diminished use of steroids makes the use of alkylating agents reasonable for children with nephrosis who show signs of decreased growth velocity.