Growth hormone treatment in children with chronic renal failure: A meta-analysis of randomized controlled trials

Objective: To evaluate the benefits and side effects of recombinant human growth hormone (hGH) treatment in children with chronic renal failure. Methods: Two reviewers independently assessed relevant randomized controlled trials for methodologic quality, extracted data, and estimated summary treatment effects by use of a random effects model. Results: Ten randomized controlled trials involving 481 children were identified. Treatment with hGH (28 IU/m(2)/wk) resulted in a significant increase in height standard deviation score at I year (4 trials, weighted mean difference [WMD] = 0.77, 95% Cl = 0.51 to 1.04), and a significant increase in height velocity at 6 months (2 trials, WMD = 5.7 cm/y, 95% Cl 4.4 to 7.0) and I year (2 trials, WMD = 4.1 cm/y, 95% CI 2.6 to 5.6), but there was no further increase in height indexes during the second year of administration. Compared with the 14 IU/m(2)/wk group, there was an increase of 1.4 cm/y (0.6 to 2.2) in height velocity in the group treated with 28 IU/m(2)/wk. The frequency of reported side effects of hGH were similar to that of the control group. Conclusion: On average, I year of treatment with 28 IU/m(2)/wk hGH in children with chronic renal failure results in an increase of 4 cm/y in height velocity above that of untreated control subjects, but there was no demonstrable benefit for longer courses or higher doses of treatment.