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Growth hormone, IGF-I and its binding proteins (IGFBP-1 and -3) in adult uraemic patients undergoing peritoneal dialysis and haemodialysis

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Summary objective 

The GH/IGF axis is altered in chronic renal failure (CRF). CRF patients usually show normal or high serum concentrations of GH and IGF-I, whereas all IGF binding proteins (IGFBP-1 to -6), except IGFBP-5, considerably increase with declining renal function. The aims of the present study were to quantify serum concentrations of GH, IGF-I, IGFBP-1 and IGFBP-3 in a group of patients with CRF, and determine whether there were differences according to the type of dialysis, that is, peritoneal dialysis (PD) and haemodialysis (HD). design 

A cross-sectional study in the setting of a dialysis unit of a general hospital. patients and measurements 

We studied 108 dialysis patients treated by PD (n = 54, 32 males and 22 females, mean age 61·0 ± 1·4 years) or HD (n = 54, 31 males and 23 females, age 62·6 ± 1·5 years). A group of 42 healthy subjects of similar age, sex and body mass index (BMI) served as the control group. Baseline serum concentrations of GH, insulin, IGF-I, IGFBP-1 and IGFBP-3 were measured in all patients and control subjects. results 

Fasting serum concentrations of IGF-I and its binding proteins (IGFBP-1 and IGFBP-3) were significantly higher in dialysis patients than in subjects with normal renal function. IGF-I (248·9 ± 23·4 vs. 205·5 ± 15·5 µg/l, NS), IGFBP-3 (5·6 ± 0·4 vs. 5·5 ± 0·2 mg/l, NS) and IGFBP-1 (36·1 ± 5·9 vs. 44·1 ± 6·5 µg/l, NS) concentrations were similar in both groups of dialysis (PD vs. HD) patients. However, GH (2·3 ± 0·3 vs. 1·1 ± 0·1 µg/l, P < 0·001) and insulin (40·4 ± 4·5 vs. 30·1 ± 3·1 µU/ml, P < 0·05) levels were significantly higher in the PD group than in the HD group. Both groups of dialysis patients showed significantly higher levels of insulin than healthy subjects (14·7 ± 1·9 µU/ml, P < 0·0001 and P < 0·01 for PD and HD, respectively). In both groups of dialysis patients, IGF-I correlated inversely with IGFBP-1 (PD group r = −0·46, P = 0·0006; HD group r = −0·57, P = 0·0001) and directly with IGFBP-3 (PD group r = 0·44, P = 0·001; HD group r = 0·73, P = 0·001). No correlation between insulin and IGFBP-1 was found in any of the groups studied. conclusions 

These findings demonstrate that adult dialysis patients have elevated IGF-I, IGFBP-1 and IGFBP-3 serum concentrations compared with subjects with normal renal function. Only GH and insulin show statistically significant differences in relation to type of dialysis. Finally, the negative correlation between IGF-I and IGFBP-1 and the positive correlation between IGF-I and IGFBP-3 are maintained in both groups of adult dialysis patients.
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Document Type: Research Article

Affiliations: 1: Departments of Endocrinology and 2: Nephrology. Hospital General, Segovia, 3: Department of Endocrinology, Hospital Ramón y Cajal, Madrid, Departments of 4: Biochemistry and 5: Nephrology, Hospital La Paz, Madrid and 6: Department of Nephrology, Hospital La Princesa, Madrid, Spain

Publication date: June 1, 2004

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