Plasma and urinary growth hormone and insulin-like growth factor I in children with chronic renal insufficiency

Area of Science:

• Pediatric Endocrinology
• Nephrology
• Growth Hormone Research

Background:

• Chronic renal insufficiency (CRI) can impact growth and development in children.
• Growth hormone (GH) and insulin-like growth factor-I (IGF-I) are critical regulators of linear growth.
• Altered GH and IGF-I metabolism is suspected in pediatric CRI but requires further elucidation.

Purpose of the Study:

• To investigate plasma and urinary growth hormone (GH) levels.
• To assess plasma insulin-like growth factor-I (IGF-I) concentrations.
• To explore the relationship between GH excretion and renal function in children with CRI.

Main Methods:

• Measured plasma GH, urinary GH, and plasma IGF-I in 15 children with CRI (8 prepubertal, 7 pubertal).
• Assessed short stature in pubertal patients using standard deviation scores.
• Correlated urinary GH excretion with creatinine clearance.

Main Results:

• Significantly elevated plasma GH and IGF-I levels were observed in pubertal subjects (p < 0.05).
• Urinary GH levels were significantly increased in both prepubertal and pubertal subjects (p < 0.001 and p < 0.05, respectively).
• An inverse correlation was found between urinary GH excretion and creatinine clearance (r = -0.55, p < 0.05).

Conclusions:

• Children with CRI exhibit complex alterations in GH and somatomedin metabolism.
• Elevated plasma and urinary GH, along with IGF-I, suggest both central and peripheral (receptor) level dysregulation.
• These findings highlight the intricate impact of renal insufficiency on the GH/IGF-I axis in pediatric patients.