Growth Retardation in Children with Kidney Disease

Figure 2

GH-IGF-I physiology. Several abnormalities in the GH and IGF-I axis in pediatric patients with CKD. IGF-I resistance likely reflects an increase in circulating IGFBP-1, -2, -4, and -6, which lead to a reduction in bioavailability IGF-I. In addition, increased IGFBP3 proteolysis leads to a reduction in the IGF-I-IGFBP3-ALS complex. The reduced IGF-I bioavailability and increased concentration of IGFBP-1 and -2 in patients with CKD are thought to contribute to the lack of GH responsiveness. In addition the direct GH effects on bone are inhibited.