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REVIEW ARTICLE
Year : 2012  |  Volume : 16  |  Issue : 2  |  Page : 195-203

Growth hormone in chronic renal disease


1 Department of Endocrinology, Jaslok Hospital and Research Centre, Mumbai, India
2 Department of Endocrinology, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore

Correspondence Address:
Vishal Gupta
15 - Dr. Deshmukh Marg, Pedder Road, Mumbai
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.93736

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Severe growth retardation (below the third percentile for height) is seen in up to one-third children with chronic kidney disease. It is thought to be multifactorial and despite optimal medical therapy most children are unable to reach their normal height. Under-nutrition, anemia, vitamin D deficiency with secondary hyperparathyroidism, metabolic acidosis, hyperphosphatemia, renal osteodystrophy; abnormalities in the growth hormone/insulin like growth factor system and sex steroids, all have been implicated in the pathogenesis of growth failure. Therapy includes optimization of nutritional and metabolic abnormalities. Failure to achieve adequate height despite 3-6 months of optimal medical measures mandates the use of recombinant GH (rGH) therapy, which has shown to result in catch-up growth, anywhere from 2 cm to 10 cm with satisfactory liner, somatic and psychological development.


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