The Effect of Recombinant Human Growth Hormone on Growth in Children with Nephropathy Receiving Long-term Steroid Therapy

ABSTRACT

PURPOSE: Growth retardation is one of the serious problems in children with nephropathy requiring long-term steroid therapy. We observed the efficacy and safety of recombinant human growth hormone(rhGH) on the growth in children with long-term steroid therapy. METHODS: We studied 60 children(male 47, female 13) with nephropathy who received rhGH (1 U/kg/week) for more than 0.5 years(1.39+/-1.12). Their mean age was 11.0 years (11.17+/-2.62). They received steroid therapy from January 1987 through July 2005, and the mean duration of steroid therapy was 4.32+/-2.97 years. Among the patients, there were 32 nephrotic syndrome, 9 IgA nephropathy, 4 mesangial proliferative glomerulonephritis, 4 focal segmental glomerulosclerosis, 2 Henoch Schonlein nephritis, 2 Alport syndrome and 7 other cases. Data were gathered on the growth parameters, such as growth velocity, height standard deviation score(SDS), IGF-1, IGFBP-3, bone mass density(BMD) and general chemistry changes. RESULTS: Height velocity increased significantly with rhGH therapy from 3.29+/-1.95 to 8.66+/-3.75(cm/yr) and height SDS decreased from -0.72+/-0.93 to -1.04+/-0.86 at one year after steroid therapy but increased to -0.55+/-0.96 at one year after rhGH administration(P<0.05). BMD improved from 0.71+/-0.14 to 0.79+/-0.15 g/cm2(P<0.05). IGF-1 increased from 445.09+/-138.01 to 506.62+/-181.31 ng/mL(P<0.05). IGFBP-3 decreased from 4073.75+/-700.78 to 3933.61+/-789.25 ug/L numerically, but there was no statistically significant difference(P=0.533). CONCLUSION: The administration of rhGH in the short stature patients who received long- term steroid therapy showed improvement in growth parameters such as SDS, growth velocity, and BMD without significant side-effects or changes in the biochemical parameters.