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Published in: Pediatric Nephrology 1/2018

01-01-2018 | Original Article

Near-adult height in male kidney transplant recipients started on growth hormone treatment in late puberty

Authors: Silvia Gil, Mariana Aziz, Marta Adragna, Marta Monteverde, Alicia Belgorosky

Published in: Pediatric Nephrology | Issue 1/2018

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Abstract

Background

Growth retardation and its impact on adult height is considered to be one of the most common complications in patients with chronic kidney disease (CKD). Treatment with recombinant human growth hormone (rhGH) has been effective in improving growth in kidney transplantation (KTx) patients, but little data are available on adult height in patients who began rhGh treatment in late puberty.

Methods

Near-adult height was evaluated in 13 KTx patients treated with rhGH [growth hormone group (GHGr); dose 9.33 mg/m2 per week] for a period of at least 18 months. At initiation of rhGH treatment, testicular volume was >8 ml and serum testosterone was >1 ng/ml compared with the control group (CGr) of ten KTx patients who did not receive rHGH. All subjects were of similar chronological age and bone age and had similar creatinine clearance (CrCl) levels, cumulative corticoid dose, height standard deviation score (SDS), target height SDS, and target height:initial height at the beginning of the study.

Results

Near-adult height was significantly greater in the GHGr than in the CGr (−1.8 ± 0.8 vs. −2.9 ± 1.1; p = 0.018). The difference between initial height and near-adult height in the GHGr revealed a significant height gain (initial height −3.1 ± 1.1; near-adult height −1.8 ± 0.8 SDS, respectively; delta 1.2 ± 0.3; p = 0.021). The CrCl level was not significantly different between the GHGr and CGr at either at study initiation or when attaining near-adult height (p = 0.74 and p = 0.23, respectively).

Conclusions

Treatment with rhGH was effective in improving adult height in KTx patients who began treatment in late puberty, without any effect on renal function.
Literature
1.
go back to reference Ugarte F, Irarrazabal C, Oh J, Dettmar A, Ceballos ML, Rojo A, Ibacache MJ, Suazo C, Lozano M, Delgado I, Cavada G, Azocar M, Delucchi A, Cano F (2016) Impaired phosphorylation of JAK2-STAT5b signaling in fibroblasts from uremic children. Pediatr Nephrol 31:965–974CrossRefPubMed Ugarte F, Irarrazabal C, Oh J, Dettmar A, Ceballos ML, Rojo A, Ibacache MJ, Suazo C, Lozano M, Delgado I, Cavada G, Azocar M, Delucchi A, Cano F (2016) Impaired phosphorylation of JAK2-STAT5b signaling in fibroblasts from uremic children. Pediatr Nephrol 31:965–974CrossRefPubMed
2.
go back to reference Schaefer F, Veldhuis JD, Robertson WR, Dunger D, Schärer K (1994) Immunoreactive and bioactive luteinizing hormone in pubertal patients with chronic renal failure. Cooperative study group on pubertal development in chronic renal failure. Kidney Int 45:1465–1476CrossRefPubMed Schaefer F, Veldhuis JD, Robertson WR, Dunger D, Schärer K (1994) Immunoreactive and bioactive luteinizing hormone in pubertal patients with chronic renal failure. Cooperative study group on pubertal development in chronic renal failure. Kidney Int 45:1465–1476CrossRefPubMed
3.
go back to reference Fine RN (2007) Management of growth retardation in pediatric recipients of renal allografts. Nat Clin Pract Nephrol 3:318–324CrossRefPubMed Fine RN (2007) Management of growth retardation in pediatric recipients of renal allografts. Nat Clin Pract Nephrol 3:318–324CrossRefPubMed
4.
go back to reference Gil S, Vaiani E, Guercio G, Ciaccio M, Turconi A, Delgado N, Rivarola MA, Belgorosky A (2012) Effectiveness of rhGH treatment on final height of renal-transplant recipients in childhood. Pediatr Nephrol 27:1005–1012CrossRefPubMed Gil S, Vaiani E, Guercio G, Ciaccio M, Turconi A, Delgado N, Rivarola MA, Belgorosky A (2012) Effectiveness of rhGH treatment on final height of renal-transplant recipients in childhood. Pediatr Nephrol 27:1005–1012CrossRefPubMed
5.
go back to reference Nissel R, Lindberg A, Mehls O, Haffner D, Pfizer International Growth Database (KIGS) International Board (2008) Factors predicting the near-final height in growth hormone-treated children and adolescents with chronic kidney disease. J Clin Endocrinol Metab 93:1359–1365CrossRefPubMed Nissel R, Lindberg A, Mehls O, Haffner D, Pfizer International Growth Database (KIGS) International Board (2008) Factors predicting the near-final height in growth hormone-treated children and adolescents with chronic kidney disease. J Clin Endocrinol Metab 93:1359–1365CrossRefPubMed
6.
go back to reference Hokken-Koelega A, Stijnen T, de Ridder MA, de Muinck Keizer-Schrama SM, Wolff ED, de Jong MC, Donckerwolcke RA, Groothoff JW, Blum WF, Drop SL (1994) Growth hormone treatment in growth-retarded adolescents after renal transplant. Lancet 343:1313–1317CrossRefPubMed Hokken-Koelega A, Stijnen T, de Ridder MA, de Muinck Keizer-Schrama SM, Wolff ED, de Jong MC, Donckerwolcke RA, Groothoff JW, Blum WF, Drop SL (1994) Growth hormone treatment in growth-retarded adolescents after renal transplant. Lancet 343:1313–1317CrossRefPubMed
7.
go back to reference Maxwell H, Rees L (1998) Randomised controlled trial of recombinant human growth hormone in prepubertal and pubertal renal transplant recipients. Arch Dis Child 79:481–487CrossRefPubMedPubMedCentral Maxwell H, Rees L (1998) Randomised controlled trial of recombinant human growth hormone in prepubertal and pubertal renal transplant recipients. Arch Dis Child 79:481–487CrossRefPubMedPubMedCentral
8.
go back to reference Janssen F, Van Damme-Lombaerts R, Van Dyck M, Hall M, Schurmans T, Herman J, Hooghe L, Van Damme B (1997) Impact of growth hormone treatment on a Belgian population of short children with renal allografts. Pediatr Transplant 1:190–196PubMed Janssen F, Van Damme-Lombaerts R, Van Dyck M, Hall M, Schurmans T, Herman J, Hooghe L, Van Damme B (1997) Impact of growth hormone treatment on a Belgian population of short children with renal allografts. Pediatr Transplant 1:190–196PubMed
9.
go back to reference Tanner JM, Whitehouse RH, Takaishi M (1966) Standards from birth to maturity for height, weight, height velocity, and weight velocity British children 1965. Arch Dis Child 219:454–471CrossRef Tanner JM, Whitehouse RH, Takaishi M (1966) Standards from birth to maturity for height, weight, height velocity, and weight velocity British children 1965. Arch Dis Child 219:454–471CrossRef
10.
go back to reference Guerlich WW, Pyle SI (1959) Radiographic atlas of skeletal development of the hand and wrist. Stanford University Press, Stanford Guerlich WW, Pyle SI (1959) Radiographic atlas of skeletal development of the hand and wrist. Stanford University Press, Stanford
11.
go back to reference Schwartz GJ, Brion LP, Spitzer A (1987) The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am 34:571–590CrossRefPubMed Schwartz GJ, Brion LP, Spitzer A (1987) The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am 34:571–590CrossRefPubMed
12.
go back to reference Fujii H, Chikamoto H, Akioka Y, Hattori M (2014) Final adult height in kidney recipients who underwent highly successful transplantation as children: A single-center experience. Clin Exp Nephrol 18:515–520CrossRefPubMed Fujii H, Chikamoto H, Akioka Y, Hattori M (2014) Final adult height in kidney recipients who underwent highly successful transplantation as children: A single-center experience. Clin Exp Nephrol 18:515–520CrossRefPubMed
13.
go back to reference Mehls O, Wühl E, Tönshoff B, Schaefer F, Nissel R, Haffner D (2008) Growth hormone treatment in short children with chronic kidney disease. Acta Paediatr 97:1159–1164CrossRefPubMed Mehls O, Wühl E, Tönshoff B, Schaefer F, Nissel R, Haffner D (2008) Growth hormone treatment in short children with chronic kidney disease. Acta Paediatr 97:1159–1164CrossRefPubMed
14.
go back to reference Fine RN, Stablein D (2005) Long-term use of recombinant human growth hormone in pediatric allograft recipients: A report of the NAPRTCS transplant registry. Pediatr Nephrol 20:404–408CrossRefPubMed Fine RN, Stablein D (2005) Long-term use of recombinant human growth hormone in pediatric allograft recipients: A report of the NAPRTCS transplant registry. Pediatr Nephrol 20:404–408CrossRefPubMed
15.
go back to reference Bérard E, André JL, Guest G, Berthier F, Afanetti A, Cochat P, Michel Broyer M, French Society for Pediatric Nephrology (2008) Long-term results of rhGH treatment in children with renal failure: Experience of the French Society of Pediatric Nephrology. Pediatr Nephrol 23:2031–2038CrossRefPubMed Bérard E, André JL, Guest G, Berthier F, Afanetti A, Cochat P, Michel Broyer M, French Society for Pediatric Nephrology (2008) Long-term results of rhGH treatment in children with renal failure: Experience of the French Society of Pediatric Nephrology. Pediatr Nephrol 23:2031–2038CrossRefPubMed
17.
go back to reference Hodson EM, Willis NS, Craig JC (2012) Growth hormone for children with chronic kidney disease. Cochrane Database Syst Rev 2:CD003264 Hodson EM, Willis NS, Craig JC (2012) Growth hormone for children with chronic kidney disease. Cochrane Database Syst Rev 2:CD003264
18.
go back to reference Haffner D, Schaefer F, Nissel R, Wühl E, Tönshoff B, Mehls O (2000) Effect of growth hormone treatment on the adult height of children with chronic renal failure. German study Group for Growth Hormone Treatment in chronic renal failure. N Engl J Med 343:923–930CrossRefPubMed Haffner D, Schaefer F, Nissel R, Wühl E, Tönshoff B, Mehls O (2000) Effect of growth hormone treatment on the adult height of children with chronic renal failure. German study Group for Growth Hormone Treatment in chronic renal failure. N Engl J Med 343:923–930CrossRefPubMed
Metadata
Title
Near-adult height in male kidney transplant recipients started on growth hormone treatment in late puberty
Authors
Silvia Gil
Mariana Aziz
Marta Adragna
Marta Monteverde
Alicia Belgorosky
Publication date
01-01-2018
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 1/2018
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-017-3777-2

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