Journal of Clinical Pediatrics ›› 2019, Vol. 37 ›› Issue (5): 381-.doi: 10.3969/j.issn.1000-3606.2019.05.014

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The treatment of recombinant human growth hormone for children on chronic peritoneal dialysis

ZHAI Yihui, XU Hong, SHEN Qian, CAO Qi, FANG Xiaoyan   

  1. Division of Nephrology, Children’s Hospital of Fudan University, Shanghai Kidney Development & Pediatric Kidney Disease Research Center, Shanghai 201102, China
  • Online:2019-05-15 Published:2019-05-15

Abstract: Objective Growth retardation is a common and significant problem for children with end stage renal disease (ESRD). It has a serious impact on adult life and may increase mortality. Treatment of ESRD with dialysis may not completely successful in restoring normal growth. Recombinant human growth hormone (rhGH) may be an effective treatment for dialysis children to gain linear growth. The treatment of rhGH has not routinely been used for children on dialysis in China. We performed this retrospective analysis to study the effect of rhGH on improving linear growth of ESRD children on peritoneal dialysis (PD). Methods Clinical data of two ESRD children with chronic PD received rhGH treatment after exclusion of contraindication was retrospectively analyzed. The dose was 0.15 IU/kg iH qd x 6 days/week, for 8 months. Results Both patients were female with short stature at diagnosis of ESRD at the age of 8 years and 8 months and 9 years and 6 months, respectively. After one year of PD, case 1 experienced faster linear growth (Height SDS increased from -1.9 to -1.4). However, case 2 still had short stature (Height SDS decreased from -2.3 to -2.4). After 8 months of rhGH treatment, both cases had significantly increased growth velocity (P=0.014). Case 1 grew 7.5 cm during 8 months of rhGH treatment. Case 2 grew 9 cm during 8 months of rhGH treatment. After discontinuation of rhGH treatment for 8 months, the growth velocity of both cases significantly decreased again (P=0.042), although the height SDS still improved (Case 1, Height SDS increased from -0.7 to -0.4. Case 2, Height SDS increased from -2.4 to -2.2). Case 1 grew 5.8 cm 8 months after discontinuation of rhGH treatment, while case 2 grew 4.5 cm. Conclusion Uremia adversely affects linear growth of children. PD can partially improve the height growth. rhGH treatment can further increase the linear growth. No obvious side effects were observed in 8 months of rhGH treatment.

Key words:  recombinant human growth hormone; end stage renal disease; peritoneal dialysis; short stature