Growth hormone reverses growth problems in children with kidney failure

Growth hormone therapy can help reverse growth problems in children with kidney failure, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN). However, treatment increases bone turnover and interrupts the relationship between bone turnover and a blood marker of bone health, making it difficult for doctors to assess patients' bone health by blood tests alone.

can have severe effects on growth in children, leading to and problems with both physical and psychological health. Abnormally high or abnormally low bone turnover can increase the severity of growth retardation in children with kidney disease, so finding a normal balance is important. Recombinant human growth hormone can often help, but response is variable in children on dialysis.

To evaluate the direct effect of recombinant therapy on the skeleton in pediatric patients, Justine Bacchetta MD, PhD, Katherine Wesseling-Perry MD (David Geffen School of Medicine at UCLA) and their colleagues randomized 33 pediatric to therapy with or without growth hormone.

Among the major findings:

  • Growth hormone therapy resulted in greater increases in height.
  • Growth hormone enhanced bone turnover in patients with baseline low bone turnover, but it counteracted the bone-turnover lowering effects of vitamin D therapy in patients with high bone turnover.
  • values were similar in patients who received growth hormone compared with those who did not, despite marked differences in final rates of bone formation.
"Pediatric patients treated with growth hormone had better improvements in height than those on standard therapy. The therapy enhanced bone turnover in patients with baseline low bone turnover while not altering bone formation in patients with high bone turnover," said Dr. Wesseling-Perry. "Unfortunately, growth hormone interrupts the relationship between bone turnover and parathyroid hormone—a marker that is used to judge bone health in these patients—making it difficult to assess bone health by blood tests alone," she added.

The findings suggest that growth hormone may help treat poor growth and low bone turnover in children on dialysis. It may also improve growth in the children with high bone turnover, but it may not benefit their overall bone health.

More information: The article, entitled "The Skeletal Consequences of Growth Hormone Therapy in Dialyzed Children: A Randomized Trial," will appear online on April 4, 2013, doi: 10.2215/CJN.00330112

add to favorites email to friend print save as pdf

Related Stories

Growth hormone safe for infants with chronic kidney failure

Jun 03, 2010

Infants with chronic renal failure (CRF) grow slowly, a problem that usually improves with aggressive nutritional therapy. When it doesn't, growth hormone is a safe and effective treatment to promote growth, according to ...

Growth hormone increases bone formation in obese women

Nov 29, 2011

In a new study presented today at the annual meeting of the Radiological Society of North America (RSNA), growth hormone replacement for six months was found to increase bone formation in abdominally obese women.

Recommended for you

Student seeks to improve pneumonia vaccines

14 hours ago

Almost a million Americans fall ill with pneumonia each year. Nearly half of these cases require hospitalization, and 5-7 percent are fatal. Current vaccines provide protection against some strains of the ...

Seabed solution for cold sores

16 hours ago

The blue blood of abalone, a seabed delicacy could be used to combat common cold sores and related herpes virus following breakthrough research at the University of Sydney.

Better living through mitochondrial derived vesicles

Aug 19, 2014

(Medical Xpress)—As principal transformers of bacteria, organelles, synapses, and cells, vesicles might be said to be the stuff of life. One need look no further than the rapid rise to prominence of The ...

Zebrafish help to unravel Alzheimer's disease

Aug 19, 2014

New fundamental knowledge about the regulation of stem cells in the nerve tissue of zebrafish embryos results in surprising insights into neurodegenerative disease processes in the human brain. A new study by scientists at ...

User comments