Sept. 27, 2000 -- Children who are unusually short because of chronic medical conditions such as kidney disease can gain several inches in height by taking growth hormone before they hit puberty. These inches stay with the child as they pass through their teens and into adulthood, according to a new study.
Most of these children can increase their final adult height by an average of nearly two inches, which can mean the difference, "between being extraordinarily short" or "being up in the normal range, although in the shorter end of normal," says Jay Cohen, MD.
Cohen, who is clinical associate professor of endocrinology at the University of Tennessee in Memphis, says being short may seem like a "small" issue to some people, but it poses many practical limitations that may be avoidable by adding just a few inches with growth hormone treatments during a child's peak growth period.
"If you're an adult and you're 4-foot-7, how do you find a car where you can reach the pedals?" says Cohen, who also has a private practice. "But if you're 5-foot-1, you can drive a car and you don't have to have specially built brake pedals, gas pedals, you can see [over the dashboard], etc. There is also discrimination in the workplace if you are profoundly short," he adds.
Growth hormone was approved in the U.S. in 1985 for use in children whose bodies don't produce enough natural growth hormone because of a deficiency or medical problems that interfere with growth, such as kidney failure. Actor Gary Coleman, best known for his role as Arnold on the sitcom Diff'rent Strokes is one example of someone whose growth was severely stunted by childhood kidney disease.
Today, growth hormone is widely used, but doctors are still compiling data on how significantly the hormone ultimately improves the child's height when they become an adult. Some have suggested the hormone may give an initial boost in growth around the time of puberty that is not sustained through the teenage years, up to the time a person's height is finally determined.
But a new study in the Sept. 28 issue of The New England Journal of Medicine shows that kids with kidney disease who took the hormone shots starting from around the age of 10 until their mid teens had sustained increases in their growth until they reach their final adult height at age 18 for boys and age 16 for girls. Compared with a similar group of children with kidney disease who did not take the hormone shots, those who did gained enough inches to put them in the normal or near-normal range for height.
That meant that boys who took the hormone were an average of 5 feet 4 inches tall as adults and girls were an average of 5 feet 1 inch tall. Among those who did not take the hormone shots, boys were an average of 5 feet 3 inches tall as adults and girls were an average of 4 feet 9 inches tall. Children who took the hormone were slightly shorter at the start of the study than children who did not take it.
The German study, led by Dieter Haffner, MD, of University Children's Hospital in Heidelberg, also shows that growth hormone does not worsen the child's kidney disease or interfere in any way with treatment of the disease, says Cohen. There also were no side effects of the treatment reported. That is likely to be important news to parents and doctors weighing the benefits of giving the growth hormone treatments to children with kidney disease.