C Bizzarri1, A Lonero2, M Delvecchio2, L Cavallo2, M F Faienza2, M Giordano3, L Dello Strologo4, M Cappa5. 1. Unit of Endocrinology and Diabetes, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy. carla.bizzarri@opbg.net. 2. Department of Biomedicine and Human Oncology/Pediatric Section, University A. Moro, Bari, Italy. 3. Pediatric Nephrology and Dialysis Unit, Children's Hospital Giovanni XXIII, Bari, Italy. 4. Unit of Pediatric Nephrology and Renal Transplant, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. 5. Unit of Endocrinology and Diabetes, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.
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.
PURPOSE:Growth retardation is a common complication of chronic kidney disease (CKD) in children. Treatment with recombinant humangrowth 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.
Entities:
Keywords:
Child; Chronic kidney disease; Growth hormone; Height; Nutritional status
Authors: A C Hokken-Koelega; T Stijnen; R C de Jong; R A Donckerwolcke; J W Groothoff; E D Wolff; W F Blum; S M de Muinck Keizer-Schrama; S L Drop Journal: Kidney Int Suppl Date: 1996-01 Impact factor: 10.545
Authors: A C Hokken-Koelega; T Stijnen; S M de Muinck Keizer-Schrama; J M Wit; E D Wolff; M C de Jong; R A Donckerwolcke; N C Abbad; A Bot; W F Blum Journal: Lancet Date: 1991-09-07 Impact factor: 79.321
Authors: E Cacciari; S Milani; A Balsamo; E Spada; G Bona; L Cavallo; F Cerutti; L Gargantini; N Greggio; G Tonini; A Cicognani Journal: J Endocrinol Invest Date: 2006 Jul-Aug Impact factor: 4.256
Authors: Cheryl P Sanchez; Beatriz D Kuizon; William G Goodman; Barbara Gales; Robert B Ettenger; M Inez Boechat; Yang Wang; Robert Elashoff; Isidro B Salusky Journal: Pediatr Nephrol Date: 2002-05 Impact factor: 3.714