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Effect of chronic renal failure and prednisolone on the growth hormone-insulin-like growth factor axis

P Kapila1, J Jones, L Rees

  • 1Department of Nephrourology, Institute of Child Health, 30 Guildford Street, London WC1N 1EH, UK. piyusha@doctors.org.uk

Pediatric Nephrology (Berlin, Germany)
|January 17, 2002
PubMed

Insights

Children with chronic renal failure (CRF) exhibit reduced insulin-like growth factor (IGF) bioactivity, impacting growth. Transplanted children with slower growth rates showed lower IGF bioactivity, suggesting its role in post-transplant growth.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Growth Hormone Axis

Background:

  • Abnormalities in the growth hormone (GH)/insulin-like growth factor (IGF) axis are linked to poor growth in children with chronic renal failure (CRF) and post-transplant.
  • Steroid therapy is common in post-transplant patients and in children with normal renal function.

Purpose of the Study:

  • To investigate the impact of CRF and steroid therapy on the GH-IGF axis in children with normal and abnormal growth.
  • To assess IGF-I levels and IGF bioactivity in relation to renal function and growth rates.

Main Methods:

  • Study included 31 children with CRF (10 on dialysis), 26 renal transplant recipients, and 10 on steroid therapy with normal renal function.
  • Insulin-like growth factor I (IGF-I) and IGF bioactivity were measured using radioimmunoassay.
  • IGF binding proteins 1, 2, and 3 were also assessed, along with growth rates and steroid (prednisolone) treatment.

Main Results:

  • IGF-I levels were normal, but IGF bioactivity was significantly lower in children with reduced glomerular filtration rates (P<0.05).
  • Transplanted children with subnormal growth rates had lower IGF bioactivity compared to those with normal growth (P=0.03).
  • No significant correlation was found between IGF bioactivity and prednisolone treatment, nor between IGF binding proteins and growth.

Conclusions:

  • Reduced IGF bioactivity is associated with decreased glomerular filtration rate in children.
  • Lower IGF bioactivity may contribute to impaired growth in some post-transplant pediatric patients.
  • The GH-IGF axis and its components show complex alterations in pediatric chronic renal failure and post-transplant settings.

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