The plasma amino acid concentrations were investigated before and after 3 and 30 months of human recombinant growth hormone treatment in 7 children with chronic renal failure. The concentrations of amino acids in plasma showed characteristic changes (pretreatment vs. after 3 and 30 months of treatment): Lys 113 ± 33 vs. 162 ± 27 and 109 ± 38 μmol/l, Met 21 ± 8 vs. 31 ± 4 and 16 ± 5, Thrl05 ± 23 vs. 148 ± 60 and 118 ± 30, Ala 455 ± 109 vs. 536 ± 93 and 314 ± 60, Gin 298 ± 66 vs. 277 ± 52 and 544 ± 65, Glu 168 ± 46 vs. 209 ± 57 and 96 ± 24, Gly345 ± 137 vs. 479 ± 169 and 342 ± 95, Pro 378 ± 148 vs. 422 ± 28 and 527 ± 229, OH-Pro 33 ± 17 vs. 105 ± 23 and 97 ± 35, Se 133 ± 39 vs. 178 ± 55 and 131 ± 12 μmol/l. Long-term treatment with human recombinant growth hormone normalized plasma alanine, glutamine, and glutamic acid levels, increased the OH-Pro concentration, and did not alter the amino acid ratios of Gly/Val, Phe/Tyr, Ser/Gly, and Asn/Asp, but the Gln/Glu ratio approached the normal value.