[Physiopathology of the somatotropin axis in chronic renal insufficiency].
Many factors contribute to the growth failure of chronic renal failure: water and electrolytes disturbances, hypertonicity, phosphate or calcium wasting, secondary hyperparathyroidism, anemia, hypertension, metabolic acidosis, and malnutrition. In addition, the pubertal growth spurt is usually stunted. Growth hormone (GH) resistance is observed with low GH binding protein (GHBP) level, and normal or low IGF I levels despite elevated GH level. Elevated IGFBP levels may contribute to a reduced IGF activity, especially in dialysed patients. Glucocorticoid therapy in transplanted patients further contribute to poor growth and inhibited IGF I activity. As conventional treatments have a limited effect to improve growth, adult height is often far below -2 SD. GH therapy has proved to be successful, especially in young children, overpassing the hormonal resistance so that an adult height within the normal range may be reached.
Cabrol
S
S
Service d'explorations fonctionnelles endocriniennes, hôpital d'enfants Armand-Trousseau, Paris, France.
Houang
M
M
Le Bouc
Y
Y
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000893:Anti-Inflammatory Agents / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D006130:Growth Disorders / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology*; D013006:Growth Hormone / Q000502:physiology* / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D018969:Insulin-Like Growth Factor Binding Proteins / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000502:physiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D013256:Steroids; D014181:Transplantation Immunology; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D018969:Insulin-Like Growth Factor Binding Proteins; D013256:Steroids; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone
Physiopathologie de l'axe somatotrope dans l'insuffisance rénale chronique.