Bone Abstracts

: This study analyses the long-term effect of rhGH on final height (FH) and bone health in renal transplanted patients.

Twenty-one young adult patients, aged 17–26 years, were studied. Group A consisted of 15 patients (12 boys) who received rhGH during 3.0 years before transplantation. After transplantation three boys needed rhGH again for 3.5 years. In group B six patients (three boys) didn’t need rhGH before transplantation, three girls received rhGH afterwards for 4 years. There is nog significant difference between the two groups for median age at transplantation, median follow-up period afterward and median GFR at final evaluation. At FH (defined as adult bone age or height velocity of <1 cm/year), clinical evaluation included measurement of height and weight and GFR measurements by Cr EDTA. Lumbar spine and total body mineral content and density and body composition were studied by DXA (Discovery A).

FH was expressed as SDS (Cole 1995). We compared the lumbar spine density, expressed as standardized lumbar bone density L2–L4(sLBMD), with normative data of Belgian healthy young adults. Osteopenia was defined as a sLBMD T-score of <1.0, osteoporosis as sLBMD T-score of −2.5 SDS. Lean body mass and fat mass were expressed as percentage of the total body weight.

Median height SDS at transplantation was better in group A (S.D. −0.3) than in group B (S.D. −1.7, P=0.03). Final height SDS was no longer different. For the total group FH SDS ranged from −2.3 to +1.0 SDS. BMI SDS was within the normal range. Fat mass % was lower in group A (16.5) compared to group B (24.5) (P=0.016).

Lumbar density values were better at the moment of renal transplantation in group A, however there was no difference at final height. In both groups one patient has a osteoporotic sLBMD.

In children with chronic renal failure rhGH treatment improves height and results in better bone health at the moment of transplantation. At final height patients with rhGH before transplantation have significantly better lean body mass. Future studies in a larger cohort should confirm these data.