Effect of chronic renal failure and prednisolone on the growth hormone-insulin-like growth factor axis.
Abnormalities of the growth hormone (GH)/ insulin-like growth factor (IGF) axis have been reported in children with chronic renal failure (CRF) and post-transplant, and are thought to contribute to poor growth. This study examined the effect of CRF and steroid therapy (given post-transplant and to children with normal renal function) on the GH-IGF axis in children with normal and abnormal growth. Thirty-one children with CRF, ten on dialysis, 26 with renal transplants and ten taking steroid therapy but with normal renal function, were studied. IGF-I, measured by radioimmunoassay, was normal but IGF bioactivity was low in groups with a decreased glomerular filtration rate (P<0.05). Transplanted children growing at a subnormal growth rate had lower IGF bioactivity than those growing at a normal rate (P=0.03), but there was no such difference in bioactivity in children with CRF. There was no correlation between IGF bioactivity and prednisolone treatment. There was no correlation between IGF binding proteins 1, 2 or 3 and growth.
Kapila
P
P
Department of Nephrourology, Institute of Child Health, 30 Guildford Street, London WC1N 1EH, UK. piyusha@doctors.org.uk
Jones
J
J
Rees
L
L
D000293:Adolescent; D002096:C-Peptide / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate; D005938:Glucocorticoids / Q000627:therapeutic use*; D006128:Growth; D019382:Human Growth Hormone / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000378:metabolism; D018969:Insulin-Like Growth Factor Binding Proteins / Q000378:metabolism; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007335:Insulin-Like Growth Factor II / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000188:drug therapy* / Q000378:metabolism* / Q000503:physiopathology / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use*; D006435:Renal Dialysis; D013002:Somatomedins / Q000378:metabolism*
D002096:C-Peptide; D005938:Glucocorticoids; D007328:Insulin; D018969:Insulin-Like Growth Factor Binding Proteins; D013002:Somatomedins; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II; D011239:Prednisolone