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The effect of rhGH on height velocity and BMI in children with CKD: a report of the NAPRTCS registry

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Abstract

The aim of this investigation was to evaluate the impact of recombinant human growth hormone (rhGH) therapy on height velocity (HV), estimated glomerular filtration rate (eGFR) and body mass index (BMI) in a large cohort of children with chronic kidney disease (CKD). We reviewed longitudinal data from patients enrolled in the chronic renal insufficiency registry of the North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS). Of the 7189 patients enrolled in the registry, 827 (11.5%) received rhGH. A total of 787 children with CKD previously rhGH naïve who received rhGH for 1–4 years (median 1.5 years) were paired with 787 control patients, and over 100 of the case–controls were followed for 4 years. The control group was matched for age, gender, height and length of time in the NAPRTCS registry. Height velocity was also compared to the general U.S. population. The eGFR of the treated group (37.5 ml/min per 1.73 m2) was significantly less than that of the control group (42.3 ml/min per 1.73 m2; p < 0.001). The rhGH-treated group had a significantly greater HV standard deviation score (SDS) than the control group (p < 0.01) at each 6-months post-rhGH treatment initiation point for 2.5 years (p < 0.007). Among 220 pairs at 2 years, the height SDS of the rhGH group was 0.56 SDS higher than that of the control group (p < 0.05). Treatment with rhGH had no significant impact on the BMI or eGFR. As demonstrated in smaller cohorts, rhGH usage is associated with improved HV in children with CKD. In contrast, rhGH does not appear to have any impact on BMI or kidney function in this population of patients.

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Abbreviations

BMI:

Body mass index

CKD:

Chronic kidney disease

CRI:

Chronic renal insufficiency

eGFR:

Estimated glomerular filtration rate

HV:

Height velocity

NAPRTCS:

North American Pediatric Renal Trials and Collaborative Studies

rhGH:

Recombinant human growth hormone

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Acknowledgments

We are indebted to the secretarial support of Ms. Sharon Blend.

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Authors and Affiliations

  1. University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA

    Mouin G. Seikaly & Pamela Waber

  2. Children’s Medical Center of Dallas, 1935 Motor Street, Dallas, TX, 75235, USA

    Mouin G. Seikaly

  3. Children’s Mercy Hospital, Kansas City, MO, USA

    Bradley A. Warady

  4. The EMMES Corporation, Rockville, MD, USA

    Donald Stablein

Authors
  1. Mouin G. Seikaly
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  2. Pamela Waber
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  3. Bradley A. Warady
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  4. Donald Stablein
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Correspondence to Mouin G. Seikaly.

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Seikaly, M.G., Waber, P., Warady, B.A. et al. The effect of rhGH on height velocity and BMI in children with CKD: a report of the NAPRTCS registry. Pediatr Nephrol 24, 1711–1717 (2009). https://doi.org/10.1007/s00467-009-1183-0

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  • DOI: https://doi.org/10.1007/s00467-009-1183-0

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