Insulin-like growth factor 1 resistance in chronic renal failure.
Renal failure is characterized by endocrine and metabolic disorders, some of them being described as a state of resistance to growth hormone (GH) and/or insulin-like growth factor (IGF) 1. There is evidence for a reduced metabolic action of IGF-1 (formerly somatomedin C) in hemodialysis and kidney transplant children and in adults undergoing hemodialysis. Since the development of recombinant human (rh) IGF-1, despite strong metabolic actions, some experimental studies suggest a decrease in metabolic effects of rhIGF-1 in chronic renal failure (CRF). Preliminary reports in adult dialysis patients also stressed the possibility of a resistance to rhIGF-1 metabolic actions. The perturbed IGF-binding protein system in CRF may play an important role in modifying storage and IGF-I delivery to tissues. Also, by analogy with insulin, receptor and postreceptor defects may be involved in this condition, as suggested by rhIGF-1 resistance with aging or in obese Zucker rats. However, rhIGF-1 remains a potent anabolic factor in uremia. Further studies will therefore be necessary to clarify this IGF-1 resistance state. Such knowledge might allow physicians to reduce the amount of rhIGF-1 administered to the patients and improve the anabolic actions of rhIGF-1 during acute and chronic renal failure.
Fouque
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Department of Nephrology and Hypertension, Edouard-Herriot Hospital, Lyon, France.
D058186:Acute Kidney Injury / Q000503:physiopathology / Q000628:therapy*; D000328:Adult; D000818:Animals; D002648:Child; D004351:Drug Resistance; D013006:Growth Hormone / Q000502:physiology; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000502:physiology / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000628:therapy*; D051381:Rats; D011924:Rats, Zucker; D011994:Recombinant Proteins / Q000627:therapeutic use; D006435:Renal Dialysis; D014511:Uremia / Q000503:physiopathology / Q000628:therapy
D011994:Recombinant Proteins; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone