To determine the usefulness of growth hormone treatment among children with renal allografts, we treated nine children with functioning renal transplants who were<16 years of age and had poor growth. The nine children, who were aged 12.6±4.0 years, had (1) heights >2.5 SD less than the mean for age, (2) growth rates ≤5 cm/yr, and (3) additional growth potential, as assessed by bone age (8.9±2.8 year). Insulin-like growth factor I, thyrotropin, and thyroid hormone levels were normal for age in all children. Growth hormone treatment increased growth rates from 1.9±1.1 cm/yr to 7.2±1.8 cm/yr without accelerating skeletal maturation and without advancing pubertal status. During growth hormone treatment, serum creatinine concentration rose from 140±50 to 190±80 μmol/L (1.6±0.6 to 2.1±0.9 mg/dl) (p<0.05), and creatinine clearances decreased from 0.79±0.37 to 0.58±0.30 ml/sec per 1.73 m2 (47±22 to 35±18 ml/min per 1.73 m2) (p<0.05) but then remained stable. Growth rates of two patients returned to pretreatment rates when growth hormone treatment was discontinued after 5 and 7 months because of increased serum creatinine values. Growth hormone treatment may be useful as adjunctive therapy for increasing growth rates in selected children with renal allografts who have poor growth; however, serum creatinine concentrations should be closely monitored during such treatment.
Supported in part by the Howard Hughes Medical Institute, a Basil O'Connor Starter Research Grant from the March of Dimes, a grant from the American Heart Association-Massachusetts affiliate, a Clinical Associate Physician Award, and National Institutes of Health General Clinical Research Centers grants RR-00052 and RR-02172. Dr. Donohoue is a Carver Clininian Scientist.
Presented in part at the 22nd Annual Meeting of the American Society of Nephrology, Washington, D.C., December 1989.
