Management of growth retardation in pediatric recipients of renal allografts.

Growth retardation frequently accompanies chronic kidney disease in children. Unfortunately, this retardation persists in magnitude despite assiduous therapeutic efforts, adequate dialytic intervention, and successful transplantation. The age of the patient at transplantation, allograft function, and corticosteroid dosage are the major factors that contribute to persistent suboptimal growth following renal transplantation. Recent data indicate that the use of recombinant human growth hormone might efficaciously improve growth velocity in the persistently growth-retarded allograft recipient. Attainment of optimum final adult height is predicated on optimum height at the time of transplantation, persistent optimum allograft function, minimization or avoidance of corticosteroid treatment, and, possibly, use of recombinant human growth hormone, especially to potentially maximize the pubertal growth spurt.