ESPE Abstracts

Introduction: Growth failure represents a clinical challenge in children with chronic kidney disease (CKD). rhGH proved to be effective to enhance growth in patients (p) under conservative treatment (CT), dialysis (D), or after renal transplantation (RT).

Aims: To report the results of rhGH treatment (GHT) in pediatric patients with CKD over the last 30 years in a single pediatric tertiary center. Study rhGH effectiveness considering treatment completion and duration, as well as CKD stages. To describe adverse effects (AE) reported during treatment.

Materials and Methods: Retrospective review of pediatric CKD patients treated with rhGH from 1992 to 2022, assessing anthropometric data and AE according CKD stage and duration of treatment.

Results: 151 p were included: 75% males, mean age at start of rhGH: 12.4±2.6 years (y). The initial height (IH) was -2.9±1.1 standard deviation score (SDS), height at the end of GHT (FH): -2±1.2 SDS (P <0.0001). 83 p (55%) completed GHT, 58 (38%) interrupted it, and 10 (7%) are currently undergoing GHT. 133 p (88%) received GHT for ≥1 y. At the start of GHT, 117 p (77%) had a RT, 25 p (17%) were under CT and 9 (6%) on D. Clinical data according completion of treatment is shown in table 1, clinical data of patients with ≥1 y of treatment classified according CKD stage in table 2.

The causes of interruption of GHT were 31 % non-medical, 15.5% RT and 53,5 % AE (20.5% of the cohort). Among AE, disorders of carbohydrate metabolism were the most frequent, followed by renal complications, lymphoproliferative disease, benign cranial hypertension, hyperparatiroidism (8%, 6%, 3,3%, 0.7%, 0.7% of the cohort, respectively). AE occurred principally in RT recipients (84%).

Conclusion: All patients improved height with treatment. Patients who received complete GHT achieved a higher FH, and among them those under CT were the most benefited. AE mainly occured in transplanted patients, of which disturbances in carbohydrate metabolism were the most frequent.