ISSN:
1432-198X
Keywords:
Key words: Growth hormone receptor
;
Growth hormone binding protein
;
Growth hormone insensitivity
;
Chronic renal failure
;
Growth failure
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract. Chronic renal failure in children is associated with growth failure. While the pathogenesis of uremic growth failure is multifactorial, an abnormal growth hormone / insulin-like growth factor (GH-IGF) axis is an important contributory element. Patients with uremia exhibit insensitivity to the action of GH, as exemplified by high plasma GH levels, low IGF-I activity, and poor somatic growth. This insensitivity can be overcome by supraphysiological doses of exogenous GH. Plasma GH binding protein (GHBP, the circulating ectodomain of the GH receptor) levels are decreased in patients with renal failure, as are hepatic GH receptor levels in animal models. Since GHBP levels are thought to reflect GH receptor levels in tissues, it is likely that the uremic GH insensitivity in humans is mediated by a decreased number of GH receptors. Another implication of the low plasma GHBP is a disproportionate elevation of free plasma GH (the biologically active moiety) relative to total GH, lending additional support to the concept of GH insensitivity in uremia. GH kinetics are altered in renal failure because of: (1) inability to excrete GH and (2) changes in the bound fraction of GH in the circulation.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00866772
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