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Insulin-like growth factors (IGF) and IGF binding proteins in children with chronic renal failure

B Tönshoff1, W F Blum, O Mehls

  • 1University Children's Hospital, Heidelberg, Germany. Burkhard_Toenshoff@krzmail.krz.uni-heidelberg.de

Progress in Growth Factor Research
|January 1, 1995
PubMed

Insights

Children with chronic renal failure (CRF) experience growth issues due to impaired somatotropic hormone axis function. Elevated IGF binding proteins in CRF inhibit insulin-like growth factor (IGF) action, contributing to poor growth.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Growth Hormone Axis Biology

Background:

  • Growth retardation and catabolism in children with chronic renal failure (CRF) are complex, with the somatotropic hormone axis implicated.
  • Disturbances in insulin-like growth factor (IGF) and IGF binding protein (IGFBP) levels are observed in CRF.

Purpose of the Study:

  • To elucidate the role of the somatotropic hormone axis, particularly IGFs and IGFBPs, in the pathomechanism of growth retardation in pediatric CRF.
  • To investigate the relationship between renal dysfunction severity and alterations in IGF and IGFBP profiles.

Main Methods:

  • Review of existing clinical and experimental evidence on growth hormone (GH), IGFs, and IGFBPs in pediatric CRF.
  • Analysis of serum levels of IGF-I, IGF-II, and various IGFBPs in relation to renal function.

Main Results:

  • Serum IGF-I levels are inadequately low in end-stage renal disease (ESRD) despite elevated GH, indicating hepatic GH insensitivity.
  • Increased hepatic production and decreased renal filtration of IGFBPs (IGFBP-1, IGFBP-2, low molecular weight IGFBP-3 fragments) contribute to their elevated serum concentrations in CRF.
  • Elevated IGFBPs in CRF serum may inhibit IGF action by competing for the type 1 IGF receptor.

Conclusions:

  • The somatotropic hormone axis, specifically impaired IGF-I production and action due to altered IGFBP profiles, is a key factor in growth retardation in pediatric CRF.
  • Therapeutic strategies targeting IGF action and IGFBP modulation may be beneficial for growth in children with CRF.

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