Renal function in short‐statured children born small for gestational age and treated with growth hormone

Abstract

Background Children born small for gestational age (SGA), particularly when associated with an extremely low birthweight (ELBW), have a higher risk of renal dysfunction. Growth hormone (GH) treatment is used to treat short‐statured children born SGA; however, its effects on renal function remain elusive, especially in those born SGA with ELBW. Methods Short‐statured children born SGA (N = 42) were included. Subjects were subdivided into two groups based on their birthweight: the ELBW group (N = 15) with a birthweight of <1,000 g, and the non‐ELBW group (N = 27) with birthweights ranging between 1,000 and 2,500 g. The creatinine‐based estimated glomerular filtration rates (eGFR) before (pre‐eGFR) and 5 years after GH treatment (post‐eGFR) were compared. Correlations between eGFR, anthropometric, or birth parameters, and cumulative GH dose were evaluated using Spearman's rank correlation coefficient. Results The ELBW group had a lower pre‐ and post‐eGFR than the non‐ELBW group. Five‐year GH treatment did not significantly reduce eGFR in either group. Post‐eGFR was positively associated with gestational week and birthweight. However, the cumulative GH dose was not correlated with pre‐eGFR, post‐eGFR, or percentage change in eGFR (%ΔeGFR). The change in bodyweight standard deviation score during GH treatment was positively correlated with %ΔeGFR in the ELBW group. Conclusions The current results indicated that GH treatment was unlikely a risk for the reduction in eGFR in short‐statured children born SGA. However, eGFR should be carefully monitored, especially in those born SGA with ELBW because these subjects had lower eGFR than non‐ELBW subjects.

Reductions in estimated glomerular filtration rate during puberty in GH-treated children born small for gestational age are associated with prematurity and low birth weight, not the dosage of GH treatment

“…Therefore, concerns have been raised regarding the potential risk of GH treatment-associated catch-up growth to impair renal function in these children. Accordingly, we previously investigated the effect of GH treatment on renal function in short-statured children born SGA (n = 42) and found that 5-yr GH treatment did not decrease estimated glomerular filtration rate (eGFR) during the prepubertal period ( 14 ). In addition, the cumulative GH dosage was not correlated with changes in eGFR, indicating that GH treatment is unlikely to decrease eGFR during the prepubertal period in short-statured children born SGA ( 14 ).…”

“…Accordingly, we previously investigated the effect of GH treatment on renal function in short-statured children born SGA (n = 42) and found that 5-yr GH treatment did not decrease estimated glomerular filtration rate (eGFR) during the prepubertal period ( 14 ). In addition, the cumulative GH dosage was not correlated with changes in eGFR, indicating that GH treatment is unlikely to decrease eGFR during the prepubertal period in short-statured children born SGA ( 14 ). However, there is a significant limitation in the previous study, as we did not investigate the effect of GH treatment on renal function during puberty despite the accumulating evidence that reductions in eGFR occur during puberty in those born SGA and/or with LBW ( 15 , 16 , 17 , 18 ).…”