Pathogenic Mechanisms of Pubertal Growth Failure in Chronic Renal Failure

Abstract

Patients with chronic renal failure (CRF) are prone to growth retardation throughout childhood (Fig. 1). In infancy, growth failure in uraemic patients is attributable mainly to reduced spontaneous food intake. During mid‐childhood, when statural growth is believed to be dependent primarily upon growth hormone (GH), growth may be variably affected by CRF, ranging from growth patterns parallel to standard centile curves to complete growth arrest. In late prepuberty particularly, growth rates may be much lower than normal, and the pubertal growth spurt is usually insufficient to produce a normal adult height. While nutritional supplementation and treatment with recombinant human GH offer promising options for the treatment of growth failure in infants and prepubertal children with CRF, increasing interest is now focusing on the problem of reduced pubertal growth in uraemia.