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Updated: May 8, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
The utility of the IGF-I generation test in children with chronic kidney disease
Amira Al-Uzri1, Rita D Swinford, Thuan Nguyen
1Division of Nephrology and Hypertension, Department of Pediatrics, Oregon Health & Science University, 707 SW Gaines Rd, Mail Code: CDRCP, Portland, OR, 97239, USA, aluzria@ohsu.edu.
Insights
The insulin-like growth factor (IGF-I) generation test did not predict growth hormone (GH) response in children with chronic kidney disease (CKD). While these children showed adequate IGF-I generation and growth, the test
Area of Science:
- Pediatric Nephrology
- Endocrinology
- Growth Disorders
Background:
- Chronic kidney disease (CKD) can impact growth in children.
- Growth hormone (GH) therapy is used to improve growth in children with CKD.
- Assessing GH sensitivity is crucial for optimizing treatment.
Purpose of the Study:
- To evaluate the utility of the insulin-like growth factor (IGF-I) generation test as a marker for GH sensitivity in pediatric CKD patients.
- To determine if IGF-I generation correlates with growth response in this cohort.
Main Methods:
- A randomized cross-over study involving children with CKD.
- Administration of low-dose and high-dose GH therapy over 7-day periods.
- Measurement of serum IGF-I levels before and after GH administration.
- Long-term GH therapy at 0.05 mg/kg/day for 12 months.
- Comparison with normative data from healthy children.
Main Results:
- Sixteen children (age 2-13 years) with CKD participated.
- Adequate IGF-I generation and annualized height velocity (10.3 cm/year) were observed.
- No correlation was found between IGF-I generation and creatinine clearance or height Z-score changes.
- Serum IGF-I levels were lower than normative data but showed adequate generation.
Conclusions:
- Children with CKD respond to GH therapy with increased IGF-I and improved growth.
- The IGF-I generation test is not a reliable predictor of growth response in children with CKD.
- Further research may be needed to identify optimal biomarkers for GH therapy in pediatric CKD.
Background:
To determine if the insulin-like-growth factor (IGF-I) generation test is a marker for growth hormone (GH) sensitivity in children with chronic kidney disease (CKD).
Methods:
This was a randomized cross-over study in which children with CKD received low-dose (0.025 mg/kg/day) and high-dose (0.05 mg/kg/day) GH therapy in the framework of a 7-day IGF-I generation test. Blood samples were collected on day 1 (D1; pre-dose) and on day 8 (D8; post 7 doses) of GH therapy. All subjects received GH for 12 months at 0.05 mg/kg/day. Serum IGF-I was measured by radioimmunometric assay. Normative historic data from healthy children and those with idiopathic short stature were used for comparison.
Results:
Sixteen subjects (age 2-13 years) with creatinine clearances of between 25 and 75 ml/min/1.73 m(2) were enrolled. Annualized height velocity for all subjects was 10.3 ± 1.1 cm/year (mean ± standard deviation), with an annual change in height Z score of 0.7 ± 1.0. No correlation was found between the generated serum IGF-I levels (D8 - D1) and creatinine clearances, and with changes in height Z scores. Serum IGF-I levels on D1 and D8 in CKD subjects were lower than normative data, but with adequate IGF-I generation on D8.
Conclusions:
Children with CKD were able to respond to GH therapy with both growth and an increase in serum IGF-I levels, but the IGF-I generation test was not a good predictor of growth response in this cohort.
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