title: Impact of growth hormone hypersecretion on the adult human kidney.
abstract: Acromegaly is most often secondary to a GH-secreting pituitary adenoma with increased Insulin-like Growth Factor type 1 (IGF-1) level. The consequences of GH/IGF-1 hypersecretion reflect the diversity of action of these hormones. The genes of the GH receptor (GHR), IGF-1, IGF-1 receptor (IGF-1R) and IGF-binding proteins (IGF-BP) are physiologically expressed in the adult kidney, suggesting a potential role of the somatotropic axis on renal structure and functions. The expression of these proteins is highly organized and differs according to the anatomical and functional segments of the nephron suggesting different roles of GH and IGF-1 in these segments. In animals, chronic exposure to high doses of GH induces glomerulosclerosis and increases albuminuria. Studies in patients with GH hypersecretion have identified numerous targets of GH/IGF-1 axis on the kidney: 1) an impact on renal filtration with increased glomerular filtration rate (GFR), 2) a structural impact with an increase in kidney weight and glomerular hypertrophy, and 3) a tubular impact leading to hyperphosphatemia, hypercalciuria and antinatriuretic effects. Despite the increased glomerular filtration rate observed in patients with GH hypersecretion, GH is an inefficient treatment for chronic renal failure. GH and IGF-1 seem to be involved in the physiopathology of diabetic nephropathy; this finding offers the possibility of targeting the GH/IGF-1 axis for the prevention and the treatment of diabetic nephropathy.
authors.affiliation: Pôle cardiovasculaire et métabolique, service d'endocrinologie et maladies métaboliques, CHU de Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex 9, France.
authors.forename: Solange
authors.initials: S
authors.lastname: Grunenwald
authors.forename: Ivan
authors.initials: I
authors.lastname: Tack
authors.forename: Dominique
authors.initials: D
authors.lastname: Chauveau
authors.forename: Antoine
authors.initials: A
authors.lastname: Bennet
authors.forename: Philippe
authors.initials: P
authors.lastname: Caron
mesh_terms: D000236:Adenoma / Q000150:complications / Q000235:genetics / Q000378:metabolism; D000328:Adult; D000818:Animals; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000150:complications / Q000235:genetics / Q000378:metabolism; D019382:Human Growth Hormone / Q000235:genetics / Q000378:metabolism* / Q000494:pharmacology*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000235:genetics / Q000378:metabolism; D007668:Kidney / Q000187:drug effects* / Q000378:metabolism; D008954:Models, Biological; D017526:Receptor, IGF Type 1 / Q000235:genetics / Q000378:metabolism; D011986:Receptors, Somatotropin / Q000235:genetics / Q000378:metabolism; D051437:Renal Insufficiency / Q000209:etiology / Q000235:genetics / Q000378:metabolism
chemical_list: D011986:Receptors, Somatotropin; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D017526:Receptor, IGF Type 1