Growth hormone treatment after renal transplantation

• Verfasst von: Mehls, Otto [VerfasserIn]
• Verfasst von: Fine, Richard N. [VerfasserIn]
• Titel: Growth hormone treatment after renal transplantation
• Titelzusatz: a promising but underused chance to improve growth
• Verf.angabe: Otto Mehls, Richard N. Fine
• Jahr: 2013
• Umfang: 4 S.
• Teil: volume:28
• Teil: year:2013
• Teil: pages:1-4
• Teil: extent:4
• Fussnoten: Published online: 5 September 2012 ; Gesehen am 09.07.2021
• Titel Quelle: Enthalten in: Pediatric nephrology
• Ort Quelle: Berlin : Springer, 1987
• Jahr Quelle: 2013
• Band/Heft Quelle: 28(2013), Seite 1-4
• ISSN Quelle: 1432-198X
• DOI: doi:10.1007/s00467-012-2293-7
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1762584638

Abstract

Growth retardation remains a clinical problem in children with chronic kidney disease (CKD) prior to and during end-stage renal disease. The growth of approximately 40 % of children on dialysis is stunted. Even so, growth hormone treatment (GH) is not used in the majority of small children prior to transplantation. Also, GH is effective in improving growth after transplantation, but again, it is only rarely used in this situation mainly for fear of triggering rejection episodes. In controlled studies, the number of patients who developed rejection episodes with GH was no greater than the number in untreated controls. However, patients with prior frequent rejection episodes developed further repeated subsequent rejection episodes. Many patients with repeated rejection episodes before GH treatment have reduced renal function and are expected to proceed to dialysis or retransplantation. We believe that in these patients, early individual decisions for or against GH treatment should be made as soon as other treatment strategies, such as steroid withdrawal, have failed or are not indicated. Decisions for GH treatment at a later pubertal age come too late for significant growth response and/or improvement of final height.