Pediatric Nephrology

, Volume 6, Issue 4, pp 394–398 | Cite as

Renal effects of growth hormone. I. Renal function and kidney growth

  • Graham D. Ogle
  • Andrew R. Rosenberg
  • Gad Kainer
Invited Review


Growth hormone (GH) affects renal function and kidney growth. Pituitary-derived or recombinant human GH (rhGH), acting via insulin-like growth factor-1 (IGF-1), increases glomerular filtration rate (GFR) and renal plasma flow (RPF) in GH-deficient as well as in normal adults. Furthermore, GFR and RPF are low in hypopituitarism and elevated in acromegaly. These effects of GH on GFR and RPF have not been demonstrated in moderate renal insufficiency. IGF-1 is implicated in compensatory renal hypertrophy. Markedly elevated levels of serum GH accelerate glomerular sclerosis in rodents, although the significance of these findings for GH treatment in humans is uncertain. rhGH therapy offers great promise to children with short stature from various aetiologies. Preliminary report on the use of rhGH in children with renal disease and after renal transplantation have not shown any consistent change in kidney function, although follow-up times are short. The long-term impact of rhGH therapy on kidney function in short children needs further evaluation.

Key words

Growth hormone Insulin-like growth factor-1 Glomerular filtration rate Renal plasma flow Renal hypertrophy 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Koch VH, Lippe BM, Nelson PA, Boechat MI, Sherman BM, Fine RN (1989) Accelerated growth after recombinant human growth hormone treatment of children with chronic renal failure. J Pediatr 115:365–371Google Scholar
  2. 2.
    Tonshoff B, Mehls O, Heinrich U, Blum WF, Ranke MB, Schauer A (1990) Growth-stimulating effects of recombinant human growth hormone in children with end-stage renal disease. J Pediatr 116: 561–566Google Scholar
  3. 3.
    Darendeliler F, Hindmarsh PC, Brook CGD (1990) Non-conventional use of growth hormone: European experience. Horm Res 33: 128–136Google Scholar
  4. 4.
    Rudman D, Feller AG, Nagaraj MS, Gergans GA, Lalitha PY, Goldberg AF, Schlenker RA, Cohn L, Rudman IW, Mattson DE (1990) Effects of human growth hormone in men over 60 years old. N Engl J Med 323: 1–6Google Scholar
  5. 5.
    Jorgensen JOL, Pederson SA, Thuesen L, Jorgenson J, Ingemann-Hansen T, Shakkebaek NE, Christianson JS (1989) Beneficial effects of growth hormone treatment in GH-deficient adults. Lancet I: 1221–1225Google Scholar
  6. 6.
    Kopple JD, Hirshberg R (1990) Physiological effects of growth hormone and insulin-like growth factor on the kidney. Miner Electrolyte Metab 16:82–88Google Scholar
  7. 7.
    Fine RN (1991) Growth hormone and the kidney: the use of recombinant human growth hormone (rhGH) in growth-retarded children with chronic renal insufficiency. J Am Soc Nephrol 1: 1136–1145Google Scholar
  8. 8.
    Merimee TJ, Grant MB (1990) Growth hormone and its disorders. In: Becker KL (ed) Principles and practices of endocrinology and metabolism Lippincott, Philadelphia, Chapter 17: 125–134Google Scholar
  9. 9.
    Martha PM, Rogol AD, Veldhuis JD, Kerrigan JR, Goodman DW, Blizzard RM (1989) Alterations in the pulsatile properties of circulating growth hormone concentrations during puberty in boys. J Clin Endocrinol Metab 69: 563–570Google Scholar
  10. 10.
    Murphy LJ, Bell GI, Friesen HG (1987) Growth hormone stimulates sequential induction ofc-myc and insulin-like growth factor I expression in vivo. Endocrinology 120: 1806–1812Google Scholar
  11. 11.
    D'Ercole AJ, Stiles AD, Underwood LE (1984) Tissue concentrations of somatomedin C: further evidence for multiple sites of synthesis and paracrine or autocrine mechanisms of action. Proc Natl Acad Sci USA 81: 935–939Google Scholar
  12. 12.
    Schlechter NL, Russell SM, Spencer EM, Nicoll CS (1986) Evidence suggesting that the direct growth-promoting effect of growth hormone on cartilage in vivo is mediated by local production of somatomedin. Proc Natl Acad Sci USA 83: 7932–7934Google Scholar
  13. 13.
    Cameron DP, Burger HG, Catt KJ, Gordon E, Watts JMK (1972) Metabolic clearance of human growth hormone in patients with hepatic and renal failure, and in the isolated perfused pig liver. Metabolism 21: 895–906Google Scholar
  14. 14.
    Johnson V, Maack T (1977) Renal extraction, absorption and catabolism of growth hormone. Am J Physiol 233: F185-F196Google Scholar
  15. 15.
    Hattori N, Kato Y, Murakami Y, Hashida S, Ishikawa E, Mohri Z, Imura H (1988) Urinary growth hormone levels measured by ultrasensitive enzyme immunoassay in patients with renal insufficiency. J Clin Endocrinol Metab 66: 727–732Google Scholar
  16. 16.
    White HL, Heinbecker P, Rolf D (1949) Enhancing effects of growth hormone on renal function. Am J Physiol 157: 47–51Google Scholar
  17. 17.
    Corvilain J, Abramow M (1962) Some effects of human growth hormone on renal hemodynamics and on tubular phosphate transport in man. J Clin Invest 41: 1230–1235Google Scholar
  18. 18.
    Christiansen SJ, Gammelgaard J, Orskov H, Anderson AR, Telmer S, Parving H-H (1981) Kidney function and size in normal subjects before and during growth hormone administration for one week. Eur J Clin Invest 11: 487–490Google Scholar
  19. 19.
    Haffner D, Ritz, E, Mehls O, Rosman J, Blum W, Heinrich U, Hubinger A (1990) Growth hormone induced rise in glomerular filtration rate is not obliterated by angiotensin-converting enzyme inhibition. Nephron 55: 63–68Google Scholar
  20. 20.
    Parving HH, Noer I, Mogensen CE, Svendsen PA (1978) Kidney function in normal man during short-term growth hormone infusion. Acta Endocrinol (Copenh) 89: 796–800Google Scholar
  21. 21.
    Hirschberg R, Rabb H, Bergamo R, Kopple JD (1989) The delayed effect of growth hormone on renal function in humans. Kidney Int 35: 865–870Google Scholar
  22. 22.
    Hirschberg R, Kopple JD (1989) Evidence that insulin-like growth factor I increases renal plasma flow and glomerular filtration rate in fasted rats. J Clin Invest 83: 326–330Google Scholar
  23. 23.
    Fagin JA, Melmed S (1987) Relative increase in insulin-like growth factor I messenger ribonucleic acid in compensatory renal hypertrophy Endocrinology 120: 718–724Google Scholar
  24. 24.
    Andersson I, Billig H, Fryklund L, Hanson A-A, Isaksson O, Isgaard J, Nilsson A, Rozell B, Skottner A, Stemme S (1986) Localization of IGF-I in adult rats. Immunohistochemical studies. Acta Physiol Scand 126: 311–312Google Scholar
  25. 25.
    Underwood LE, D'Ercole AJ, Clemmons DR, Van Wyk JJ (1986) Paracrine functions of somatomedins. Clin Endocrinol Metab 15: 59–77Google Scholar
  26. 26.
    Conti FG, Striker LJ, Lesniak MA, MacKay K, Roth J, Striker GE (1988) Studies on binding and mitogenic effect of insulin and insulin-like growth factor I in glomerular-mesangial cells. Endocrinology 122: 2788–2795Google Scholar
  27. 27.
    Ichikawa I, Purkerson ML, Klahr S, Troy JL, Martinez-Meldorado M, Brenner BM (1980) Mechanism of reduced glomerular filtration rate in chronic malnutrition. J Clin Invest 65: 982–988Google Scholar
  28. 28.
    Guler H-P, Schmid C, Zapf J, Froesch ER (1989) Effects of recombinant insulin-like growth factor 1 on insulin secretion and renal function in normal human subjects. Proc Natl Acad Sci USA 86: 2868–2872Google Scholar
  29. 29.
    Levine L, Xiao D-M, Fujiki H (1986) Combinations of palytoxin or12-O-tetradecanoylphorbol-13-acetate and recombinant human insulin growth factor-I or insulin synergistically stimulate prostaglandin production in cultured rat liver cells and squirrel monkey aorta smooth muscle cells. Prostaglandins 31: 669–681Google Scholar
  30. 30.
    Falkheden T (1963) Renal function following hypophysectomy in man. Acta Endocrinol (Copenh) 42: 591–600Google Scholar
  31. 31.
    Salomon F, Cuneo RC, Hesp R, Soensken PM (1989) The effects of treatment with recombinant human growth hormone on body composition and metabolism in adults with growth hormone deficiency. N Engl J Med 321: 1797–1803Google Scholar
  32. 32.
    Dio T, Striker LJ, Quaife C, Conti FG, Palmiter R, Behringer R, Brinster R, Striker GE, (1988) Progressive glomeruloscleroisis develops in transgenic mice chronically expressing growth hormone and growth hormone releasing factor but not in those expressing insulin like growth factor-1. Am J Pathol 131: 398–403Google Scholar
  33. 33.
    Wanke R, Hermanns W, Folger S, Wolf E, Brem G (1991) Accelerated growth and visceral lesions in transgenic mice expressing foreingn genes of the growth hormone family: an overview. Pediatr Nephrol 5: 513–521Google Scholar
  34. 34.
    Kawaguchi H, Itoh K, Hayashi Y, Makino S (1991) Renal pathology in rats bearing tumour-secreting growth hormone. Pediatr Nephrol 5: 533–538Google Scholar
  35. 35.
    Heller BI, Smith RE, Lubin RI (1954) Renal functional status in patients with acromegaly. J Lab Clin Med 44: 811Google Scholar
  36. 36.
    Gershberg H, Heinemann HO, Stumpf HH (1957) Renal function studies and autopsy report in a patient with gigantism and acromegaly. J Clin Endocrinol Metab 17: 377–385Google Scholar
  37. 37.
    Ikkos D, Ljunggren H, Luft R (1956) Glomerular filtration rate and renal plasma flow in acromegaly. Acta Endocrinol (Copenh) 21: 226–236Google Scholar
  38. 38.
    Haffner D, Zacharewicz S, Mehls O, Heinrich U, Ritz E (1989) The acute effect of growth hormone on GFR is obliterated in chronic renal failure. Clin Nephrol 32: 266–269Google Scholar
  39. 39.
    Nakano M, Kainer G, Foreman JW, Ko D, Chan JCM (1989) The effects of exogenous rat growth hormone therapy on growth of uremic rats fed on an 8% protein diet. Pediatr Res 26: 204–207Google Scholar
  40. 40.
    Ter Wee PM, Geerlings W, Rosman JB, Sluiter WJ, Geest S van der, Donker AJM (1985) Testing renal reserve filtration capacity with an amino acid solution. Nephron 41: 193–199Google Scholar
  41. 41.
    Tonshoff B, Heinrich U, Mehls O (1991) How safe is the treatment of uraemic children with recombinant human growth hormoner? Pediatr Nephrol 5: 454–460Google Scholar
  42. 42.
    Christiansen JS, Gammelgaard J, Frandsen H, Parving H-H (1981) Increased kidney size, glomerular filtration rate and renal plasma flow in short-term insulin-dependent diabetes. Diabetologia 20: 451–456Google Scholar
  43. 43.
    Mogensen CE, Christensen CK (1984) Predicting diabetic nephropathy in insulin-dependent patients. N Engl J Med 311: 89–93Google Scholar
  44. 44.
    Brenner BM, Meyer TW, Hostetter TH (1982) Dietary protein intake and the progressive natur of kidney disease. N Engl J Med 307: 652–659Google Scholar
  45. 45.
    Anderson S, Brenner BM (1988) Pathogenesis of diabetic glomerulopathy: haemodynamic considerations. Diabetes Metab Rev 4: 163–177Google Scholar
  46. 46.
    Hansen AP, Johansen K (1979) Diurnal patterns of blood glucose, serum free fatty acids, insulin, glucagon and growth hormone in normals and juvenile diabetics. Diabetologia 6: 27–33Google Scholar
  47. 47.
    Hansen AP, Mogensen CE (1972) Growth hormone secretion and kidney function during normalisation of the metabolic state in newly diagnosed diabetes. Horm Metab Res 4: 11–15Google Scholar
  48. 48.
    Christiansen JS, Gammelgaard J, FrandsenM, Orskov H, Parving H-H (1982) Kidney function and size in type-1 (insulin-dependent) diabetic patients before and during growth hormone administration for one week. Diabetologia 22: 333–337Google Scholar
  49. 49.
    Seyer-Hansen K, Gunderson MJG, Osterby R (1981) Acute renal hypertrophy in experimental diabetes: lack of effect of short-term growth hormone administration. Diabetologia 21: 374–375Google Scholar
  50. 50.
    Castellino P, Giordano C, Perna A, DeFronzo RA (1988) Effects of plasma amino acid and hormone levels on renal hemodynamics in humans. Am J Physiol F444–F449Google Scholar
  51. 51.
    Bergstrom J, Ahlberg M, Alvestrand A (1985) Influence of protein intake on renal hemodynamics and plasma hormone concentrations in normal subjects. Acta Med Scand 217: 189–196Google Scholar
  52. 52.
    Kleinman KS, Glassock RJ (1986) Glomerular filtration rate fails to increase following protein ingestion in hypothalamo-hypophysealdeficient adults. Am J Nephrol 6: 169–174Google Scholar
  53. 53.
    Brouhard BH, Richards GE, LaGrone L (1989) Effect of growth hormone on the glomerular filtration response to a protein meal. J Am Coll Nutr 8: 57–60Google Scholar
  54. 54.
    Nicholson WE, Barton RN, Puett D, Orth DN, Liddle GW (1979) Evidence for renotropic activity in ovine pituitaries. Endocrinology 105: 16–20Google Scholar
  55. 55.
    Peters G (1978) Introduction: history and problems of compensatory adaptation of renal functions and of compensatory hypertrophy of the kidneys. Yale J Biol Med 51: 235–245Google Scholar
  56. 56.
    Steer KA, Sochor M, Kunjara S, Doepfner W, McLean P (1988) The effect of a Somatostatin analogue (SMS 201-995, Sandostatin) on the concentration of phosphoribosyl pyrophosphate and the activity of the pentose phosphate pathway in the early renal hypertrophy of experimental diabetes in the rat. Biochem Med Metab Biol 39: 226–233Google Scholar
  57. 57.
    Johansson G, Sietnieks A, Janssens F, Proesmans W, Vander-schueren-Lodeweyckx M, Holmberg C, Sipila I, Broyer M, Rappaport R, Albertsson-Wikland K, Berg U, Jodal U, Rees L, Rigden SPA, Preece MA (1990) Recombinant human growth hormone treatment in short children with chronic renal disease, before transplantation or with functioning renal transplants: an interim report on five Euroeean studies. Acta Paediatr Scand [Suppl] 370: 36–42Google Scholar

Copyright information

© IPNA 1992

Authors and Affiliations

  • Graham D. Ogle
    • 1
  • Andrew R. Rosenberg
    • 1
  • Gad Kainer
    • 1
  1. 1.Department of NephrologyPrince of Wales Children's HospitalSydneyAustralia

Personalised recommendations