Impact of recombinant human growth hormone treatment in children with growth disorders secondary to nephrotic syndrome.

BACKGROUND

Patients with nephrotic syndrome (NS) treated with glucocorticoids often suffer from growth disorders. This study aimed to explore the impact of recombinant human growth hormone treatment in children with growth disorders secondary to NS.

METHODS

This retrospective study enrolled patients with NS treated at Guangzhou Women and Children's Medical Center between May 2015 and November 2023. Patients were divided into the recombinant human growth hormone group and the conventional group. The primary outcome was height increment. Secondary outcomes included height standard deviation score, predicted adult height standard deviation score, and height velocity.

RESULTS

Among 129 enrolled children (89 in the recombinant human growth hormone group, 40 in the conventional group), the recombinant human growth hormone group showed significantly greater height increments at 6 months (4.80 ± 1.42 vs. 2.02 ± 0.91 cm), 12 months (9.07 ± 2.46 vs. 4.39 ± 1.73 cm), and 24 months (15.34 ± 5.20 vs. 7.88 ± 3.43 cm; all P < .001). Similarly, height standard deviation score and predicted adult height standard deviation score improvements were significantly greater in the recombinant human growth hormone group at all time points (all P < .001). Height velocity was also higher in the recombinant human growth hormone group at 6 and 12 months (both P < .001). These associations remained significant after multivariate adjustment. No significant differences in glucocorticoid exposure during follow-up were observed between groups. Multivariate analysis at 12 months indicated that cumulative glucocorticoid dosage was negatively associated with height standard deviation score (β=-.0022, 95% CI: -0.0041, -0.0004; P = .020) and predicted adult height (β=-.0148, 95% CI: -0.0288, -0.0008; P = .038).

CONCLUSION

The results suggested that recombinant human growth hormone treatment in children with NS significantly improved height, height standard deviation score, predicted adult height standard deviation score, and height velocities, compared with conventional treatment.