During the past decade, the safety and efficacy of long-term treatment with recombinant human growth hormone (rhGH) in children with chronic renal failure before and after renal transplantation has been established. This article reviews the increasing evidence that rhGH treatment also results in a significant improvement of adult height in patients with childhood-onset chronic renal failure. The eventual height benefit of extended rhGH treatment appears to be 1.0 to 1.5 standard deviations on average. Whereas prepubertal rhGH treatment has a beneficial effect on final height, the efficacy of rhGH during puberty is less evident. The cumulative duration of rhGH treatment was found to be the most important positive, and the duration of dialysis treatment periods a negative predictor of rhGH efficacy, stressing the importance of prolonged rhGH treatment starting early in the course of chronic renal failure.
Copyright 2001 by W.B. Saunders Company