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Evidence summaries

Growth Hormone for Children with Chronic Renal Failure

One year of weekly human growth hormone appears to result in a 3.9 cm/yr increase in height velocity above that of untreated controls in children with chronic renal failure, but studies were too short to determine if continuing treatment resulted in an increase in final adult height. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 16 studies with a total of 809 subjects. Treatment with human growth hormone (28 IU/m2 /wk) resulted in a significant increase in height standard deviation score (HSDS) at one year (MD 0.82, 95% CI 0.56 to 1.07; 8 studies, n=391), and a significant increase in height velocity at six months (MD 2.85 cm/6 mo, 95%CI 2.22 to 3.48; 2 studies, n=27) and one year (MD 3.88 cm/y, 95%CI 3.32 to 4.44; 7 studies, n=287). Height velocity, though reduced, remained significantly greater than untreated children during the second year of therapy (MD 2.30 cm/y, 95% CI 1.39 to 3.21; 1 study, n= 82). Compared to the 14 IU/m²/wk group, there was a 1.18 cm/y (0.52 to 1.84; 3 studies, n=150) increase in height velocity in the 28 IU/m²/wk group. The frequency of reported side effects of rhGH were similar to that of the control group.

Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment and blinding).

References

Primary/Secondary Keywords