title: Insulin-like growth factors and kidney disease.
abstract: Insulin-like growth factors (IGF-1 and IGF-2) are necessary for normal growth and development. They are related structurally to proinsulin and promote cell proliferation, differentiation, and survival, as well as insulin-like metabolic effects, in most cell types and tissues. In particular, IGFs are important for normal pre- and postnatal kidney development. IGF-1 mediates many growth hormone actions, and both growth hormone excess and deficiency are associated with perturbed kidney function. IGFs affect renal hemodynamics both directly and indirectly by interacting with the renin-angiotensin system. In addition to the IGF ligands, the IGF system includes receptors for IGF-1, IGF-2/mannose-6-phosphate, and insulin, and a family of 6 high-affinity IGF-binding proteins that modulate IGF action. Disordered regulation of the IGF system has been implicated in a number of kidney diseases. IGF activity is enhanced in early diabetic nephropathy and polycystic kidneys, whereas IGF resistance is found in chronic kidney failure. IGFs have a potential role in enhancing stem cell repair of kidney injury. Most IGF actions are mediated by the tyrosine kinase IGF-1 receptor, and inhibitors recently have been developed. Further studies are needed to determine the optimal role of IGF-based therapies in kidney disease.
authors.affiliation: Department of Endocrinology and Diabetes, Alfred Hospital, Melbourne, Victoria, Australia; Department of Medicine (Alfred), Monash University, Melbourne, Victoria, Australia. Electronic address: leon.bach@monash.edu.
authors.forename: Leon A
authors.initials: LA
authors.lastname: Bach
authors.affiliation: Baker-IDI Research Institute, Melbourne, Victoria, Australia.
authors.forename: Lorna J
authors.initials: LJ
authors.lastname: Hale
mesh_terms: D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000652:urine*; D007335:Insulin-Like Growth Factor II / Q000652:urine*; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000628:therapy / Q000652:urine*; D008297:Male; D008875:Middle Aged
chemical_list: D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II
keywords: Insulin-like growth factor (IGF); chronic kidney disease (CKD); diabetic nephropathy; growth hormone (GH); kidney development; kidney disease; kidney function