Effectiveness of growth hormone on growth and final height in paediatric chronic kidney disease,Pediatric Nephrology

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Effectiveness of growth hormone on growth and final height in paediatric chronic kidney disease
Pediatric Nephrology ( IF 3 ) Pub Date : 2021-09-06 , DOI: 10.1007/s00467-021-05259-6
Melanie K Aldridge _{1,

2,

3} , Peter Trnka _{1,

2} , Anna Francis _{1,

2} , Steven J McTaggart _{1,

2}

Affiliation

Background

The effectiveness of rhGH on growth and final height (FH) was determined in children with CKD and kidney failure using data linkage from two national databases.

Methods

Data on Australian children with CKD and kidney failure treated with rhGH were obtained by linking ANZDATA and OzGrow registries. The CKD cohort included children treated with rhGH prior to kidney replacement therapy (KRT). The KRT cohort consisted of children with kidney failure, some received rhGH, and some were untreated. Height standard deviation scores (Ht-SDS) were calculated with final height defined as last height recorded in girls > 16 years of age and boys > 17 years of age.

Results

In the CKD group, there were 214 children treated with rhGH prior to KRT. In the KRT group, there were 1,032 children, 202 (19%) treated with rhGH and 830 (81%) untreated. Growth significantly improved in the rhGH-treated CKD group (ΔHt-SDS = +0.80 [+0.68 to +0.92]; p < 0.001) and the rhGH-treated KRT group (ΔHt-SDS = +0.38 [+0.27 to +0.50]; p < 0.001). Within the KRT cohort, final height was available for 423 patients (41%), of which 137 (32%) had been treated with rhGH. The rhGH-treated group demonstrated marginally better catch-up growth (ΔHt-SDS = +0.05 [−0.18 to 0.29]) compared to the non-rhGH-treated group (ΔHt-SDS = −0.03 [−0.16 to 0.10]; p = 0.49).

Conclusions

This large linkage study confirms rhGH is effective in improving height in children with CKD pre-KRT. However, rhGH appears to have a variable impact on growth once children have commenced KRT resulting in a marginal impact on final height.

Graphical abstract

中文翻译：

生长激素对小儿慢性肾脏病患者生长和最终身高的影响

背景

使用来自两个国家数据库的数据链接，确定了 rhGH 对患有 CKD 和肾衰竭的儿童的生长和最终身高 (FH) 的有效性。

方法

通过将 ANZDATA 和 OzGrow 登记处联系起来，获得了用 rhGH 治疗的患有 CKD 和肾衰竭的澳大利亚儿童的数据。CKD 队列包括在肾脏替代治疗 (KRT) 之前接受 rhGH 治疗的儿童。KRT 队列由肾功能衰竭的儿童组成，有些接受 rhGH，有些未接受治疗。身高标准差评分 (Ht-SDS) 的最终身高定义为女孩 > 16 岁和男孩 > 17 岁的最后身高。

结果

在 CKD 组中，有 214 名儿童在 KRT 之前接受了 rhGH 治疗。在 KRT 组中，有 1,032 名儿童，其中 202 名 (19%) 接受 rhGH 治疗，830 名 (81%) 未接受治疗。rhGH 治疗的 CKD 组（ΔHt-SDS = +0.80 [+0.68 至 +0.92]；p < 0.001）和 rhGH 治疗的 KRT 组（ΔHt-SDS = +0.38 [+0.27 至 +0.50] ）的生长显着改善; p < 0.001)。在 KRT 队列中，423 名患者 (41%) 可获得最终身高，其中 137 名 (32%) 接受了 rhGH 治疗。与非 rhGH 治疗组（ΔHt-SDS = -0.03 [-0.16 至 0.10]相比， rhGH 治疗组表现出略微更好的追赶生长（ΔHt-SDS = +0.05 [-0.18 至 0.29]）； p = 0.49)。