Final height in children with chronic renal failure who have not received growth hormone

Final height (FH), growth velocity after 16 and 18 years of age, and factors predictive for FH were assessed in 60 patients (21-36 years old), whose chronic renal failure (CRF) started before the age of 16 years (28 girls and 32 boys). At 16 years of age, 22 had conservative treatment (CT, group A) and 38 end-stage renal failure [ESRF, group B, which includes 19 receiving hemodialysis (HD) and 19 with a functional renal transplant (RTx)]. None received recombinant human growth hormone (rhGH) treatment. FH was lower than in a normal population: 161.6+/-8 cm for males [-2.06+/-1.3 standard deviation score (SDS)] and 154.3+/-8.1 cm for females (-1.4+/-1.4 SDS). FH in group A (-1.15+/-1.4 SDS) was significantly higher than in group B (-2.1+/-1.3 SDS); 45% of all patients (56% of males and 23% of females) had a final height below -2 SDS (41% in group A and 47% in group B). FH was reached at 20.2+/-1.8 years in males and 18.8+/-2 years in females. A continuation of growth after 18 years of age was observed in 23 males (71.8%): +5.2 cm (+0.87 SDS) and in 14 females (50%): +1.75 cm (+0.3 SDS). However, this partial recovery concerned mainly patients with an important growth deficiency. A higher height at enrolment or at ESRF was significantly associated with a higher FH, whereas a longer period of ESRF had a significantly negative effect. In conclusion, all efforts should be made to diagnose CRF as early as possible and to try to improve growth before ESRF and RTx. Early institution of rhGH therapy should improve FH and improve the chance of achieving near-normal adult height in most patients.