IGF-1 and survival in ESRD.

Area of Science:

• Nephrology
• Endocrinology
• Metabolic Diseases

Background:

• Insulin-like growth factor 1 (IGF-1) deficiency is associated with malnutrition in chronic kidney disease (CKD) patients.
• The extent of IGF-1's association with survival in CKD patients is not well-defined.

Purpose of the Study:

• To investigate the association between serum IGF-1 levels and mortality risk in CKD stage 5 patients initiating dialysis.
• To examine the relationship between baseline IGF-1, changes in IGF-1 over the first year of dialysis, and patient survival.

Main Methods:

• Serum IGF-1 and nutritional markers were measured in 365 CKD stage 5 patients starting dialysis.
• Measurements were repeated after 1 year for 207 patients.
• Mortality was assessed over a median 5-year follow-up using Cox models.

Main Results:

• Baseline IGF-1 negatively correlated with age, diabetes, cardiovascular disease, and poor nutritional status.
• Higher baseline IGF-1 levels were associated with a reduced mortality risk (HR 0.57).
• Persistently low or decreasing IGF-1 levels during the first year of dialysis predicted worse survival (aHR 2.19).

Conclusions:

• Low serum IGF-1 in incident dialysis patients is linked to body composition and mineral/bone metabolism markers.
• Serum IGF-1 levels are a significant predictor of increased mortality risk in CKD patients undergoing dialysis.