Objectives: To study the efficacy and safety of 1 year of growth hormone (GH) therapy in children with steroid-dependent nephrotic syndrome.

Study design: A prospective pilot, open study in which GH (mean dose 0.32 mg/kg per week) was administered for 1 year to 8 children with steroid-dependent nephrotic syndrome requiring prednisolone (mean dose 0.46 mg/kg per day) to maintain remission. Steroid dependence was defined as recurrence of proteinuria within 2 weeks of discontinuation of prednisolone, or when the dose was lowered below a critical level. At entry, all patients had been steroid dependent for at least 1 year. Anthropometric and bone mineral density measurements after treatment were compared with 1-year pretreatment data.

Results: Pretreatment mean (±SD) chronologic age was 12.6 (±3.1) years, with a mean bone age of 9.1 (±2.0) years, with delayed puberty in five patients. The mean height velocity increased from 3.7 (±1.4) to 9.4 (±2.1) cm/yr after 1 year of treatment (p<0.05). The mean height standard deviation score increased from −1.4 (±1.6) to −0.3 (±1.1), (p<0.05). In the spine, the mean bone mineral density increased from 0.50 to 0.64 gm/cm² (p<0.05), and in the femoral neck, from 0.55 to 0.64 gm/cm² (p<0.05) after 1 year of treatment. Mean lean body mass increased from 58.1% to 62.6% (p<0.01). There were no significant changes in creatinine clearance, fasting glucose, fasting insulin, or glycosylated hemoglobin levels. The mean bone age increased to 11.4 (±2.4) years, and pubertal stage advanced in 2 patients.

Conclusion: One year of GH therapy is effective in improving the height standard deviation score, height velocity, bone mineral density, and lean body mass of children with steroid-dependent nephrotic syndrome. There were no significant adverse effects. However, the bone age accelerated at a greater pace than the height age, and further studies are required to define the role of GH therapy in steroid-dependent nephrotic syndrome.