For pediatric dialysis patients, growth hormone (GH) therapy is associated with an increased rate of bone formation and results in greater increases in height, according to research published online in the Clinical Journal of the American Society of Nephrology.
Justine Bacchetta, MD, of the David Geffen School of Medicine at the University of California Los Angeles, and colleagues assessed the effects of GH therapy in 33 pediatric patients with end-stage renal disease (median age, 11.7 years). Participants were randomized to therapy with GH (15 patients) or without GH (18 patients). All patients were further stratified by bone turnover rate and those with high bone turnover also received calcitriol.
The researchers found that, for patients with low bone turnover, treatment with GH was associated with a significant increase in bone formation rate per bone surface (from 15.0 to 154.6 µm²/ µm³ per year). Patients with high bone turnover treated with standard therapy had a significant decrease in bone formation rate per bone surface (from 103.3 to 60.3 µm²/ µm³ per year). The rate was unchanged in the other groups. Regardless of underlying bone histologic features, patients treated with GH had significantly higher bone formation rates and significantly greater increases in height standard deviation scores. Parathyroid hormone levels were similar among the groups.
“GH therapy improves height in pediatric dialysis patients, irrespective of underlying bone histologic features,” the authors concluded. “Bone formation rates are higher in GH recipients, and GH therapy alters the relationship between circulating parathyroid hormone values and bone turnover.”