Renal function in short-statured children born SGA treated with growth hormone.

BACKGROUND Children born small for gestational age (SGA), particularly when associated with an extremely low birth weight (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 birth weight: the ELBW group (N=15) with a birth weight of <1,000 g, and the non-ELBW group (N=27) with birth weights, ranging between 1,000 g 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 birth weight. However, the cumulative GH dose was not correlated with pre-eGFR, post-eGFR or percent change in eGFR (%ΔeGFR). The change in body weight-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.