Growth factor insensitivity in renal failure.
Advanced chronic renal failure is associated with multiple endocrine and metabolic abnormalities that result from changes in the secretion and metabolism of hormones and growth factors and the target organ sensitivity to their physiological actions. As a consequence, growth retardation, bone disease, pertubations in lipid, carbohydrate and protein metabolism are commonly seen in patients with chronic renal failure. The recent availability of recombinant growth factors has provided new therapeutic opportunities for correcting these abnormalities. However because of the presence of end-organ resistance relatively high dose therapy is required and this carries an increased risk of side effects. One logical approach to this problem would be to prevent or treat the underlying resistance and thus restore sensitivity to endogenous GH or low doses of the recombinant molecule. To achieve this goal, a better understanding of the mechanism of growth factor resistance is required. In this lecture, in honor of the memory of Frank Carone. I review our current state of knowledge of the impact of advanced renal failure on the tissue sensitivity to insulin, growth hormone and insulin-like-growth factor I.
Rabkin
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Research Service Veterans Affairs Palo Alto Health Care System, California, USA. rabkin@leland.stanford.edu
D000818:Animals; D013006:Growth Hormone / Q000378:metabolism*; D006133:Growth Substances / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D007676:Kidney Failure, Chronic / Q000378:metabolism*
D006133:Growth Substances; D007328:Insulin; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone