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Previous Volume 343:923-930 September 28, 2000 Number 13 Next

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ABSTRACT

Background Growth hormone treatment stimulates growth in short children with chronic renal failure. However, the extent to which this therapy increases final adult height is not known.

Methods We followed 38 initially prepubertal children with chronic renal failure treated with growth hormone for a mean of 5.3 years until they reached their final adult height. The mean (±SD) age at the start of treatment was 10.4±2.2 years, the mean bone age was 7.1±2.3 years, and the mean height was 3.1±1.2 SD below normal. Fifty matched children with chronic renal failure who were not treated with growth hormone served as controls.

Results The children treated with growth hormone had sustained catch-up growth, whereas the control children had progressive growth failure. The mean final height of the growth hormone–treated children was 165 cm for boys and 156 cm for girls. The mean final adult height of the growth hormone–treated children was 1.6±1.2 SD below normal, which was 1.4 SD above their standardized height at base line (P< 0.001). In contrast, the final height of the untreated children (2.1±1.2 SD below normal) was 0.6 SD below their standardized height at base line (P<0.001). Although prepubertal bone maturation was accelerated in growth hormone–treated children, treatment was not associated with a shortening of the pubertal growth spurt. The total height gain was positively associated with the initial target-height deficit and the duration of growth hormone therapy and was negatively associated with the percentage of the observation period spent receiving dialysis treatment.

Conclusions Long-term growth hormone treatment of children with chronic renal failure induces persistent catch-up growth, and the majority of patients achieve normal adult height.

Source Information

From the Division of Pediatric Nephrology, University Children's Hospital, Heidelberg, Germany.

Address reprint requests to Dr. Mehls at the Division of Pediatric Nephrology, University Children's Hospital, Im Neuenheimer Feld 150, D-69120 Heidelberg, Germany, or at otto_mehls{at}med.uni-heidelberg.de.

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