Growth retardation is a common complication in children with chronic kidney disease. Treatable causes of growth retardation in these patients include renal osteodystrophy, metabolic acidosis, and inadequate nutritional intake. In addition, disturbances in the growth hormone-insulinlike growth factor I axis are a major cause of decreased growth. Administration of recombinant human growth hormone can overcome this problem, allowing catch-up growth and achievement of normal or improved adult height.