Abstract
Children with chronic renal failure (CRF) are often growth retarded, and abnormalities of the growth hormone (GH)/insulin-like growth factor (IGF) axis in CRF may contribute to this poor growth. Despite normal IGF levels in CRF serum, IGF bioactivity is low due to excess IGF-binding proteins (IGFBPs) in the 35-kDa serum fractions. Levels of IGFBP-1, -2, -4 and -6, and a 29-kDa IGFBP-3 fragment, are high in CRF serum, and levels of intact IGFBP-1 and -2 correlate negatively with height. IGFBP-1 levels may be high due to insulin resistance, suggesting that the FKHR family of transcription factors may play a role in the overexpression of IGFBP-1, and other growth inhibitors, in CRF. GH-treated CRF children show catch-up growth that correlates positively with a rise in each component of the 150-kDa serum ternary complex (IGF-I or -II/IGFBP-3 or -5/acid-labile subunit); IGFBP-1, -2 and -6 levels do not rise, but serum IGF bioactivity does. Thus, GH increases levels of IGFs and ternary complexes in CRF serum. It is likely that increased IGFs contribute to catch-up growth by overcoming the inhibitory effects of excess IGFBPs present in the CRF milieu.
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Received: 3 May 1999 / Revised: 23 December 1999 / Accepted: 2 January 2000
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Powell, D., Liu, F., Baker, B. et al. Effect of chronic renal failure and growth hormone therapy on the insulin-like growth factors and their binding proteins. Pediatr Nephrol 14, 579–583 (2000). https://doi.org/10.1007/s004670000349
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DOI: https://doi.org/10.1007/s004670000349