Does renal osteodystrophy develop and/or progress during the course of rhGH treatment?

Recent expansion of the use of recombinant growth hormone (GH) to non-GH-deficient patients demands close attention to possible complications in these patients, including the effects on bone. Recent studies on the use of GH in children with chronic renal failure (CRF) provide some early data. In several studies of GH in CRF no significant differences in radiographic osteodystrophy scores, serum calcium, phosphorus or parathyroid hormone (PTH) levels between treated and untreated groups have been found. Alkaline phosphatase increases transiently. The effect of ROD on growth response has not yet been reported. Children with CRF treated with GH should be serially monitored for ROD with serial radiographs and for serum calcium, phosphorus, alkaline phosphatase and PTH levels.