Insulin-like growth factor i preserves renal function
postoperatively.
Franklin, Samuel C., Michael Moulton, Gregorio A. Sicard, Marc R.
Hammerman, and Steven B. Miller.
George M. O'Brien Kidney and Urological Diseases Center, Renal
Division, Departments of Internal Medicine, Surgery, and Cell Biology
and Physiology, Washington University School of Medicine, St. Louis
MO 63110
APStracts 3:0206F, 1996.
Deterioration of renal function which can lead to postoperative renal
failure is a complication of surgery involving the suprarenal aorta
and surgery involving the renal arteries. Fifty four patients who
were at risk for developing this complication were enrolled in a
double-blind, randomized placebo-controlled trial of IGF I as a
therapeutic agent to prevent the decline in renal function. The
primary end point was the incidence of renal dysfunction as defined
as a reduction of the glomerular filtration rate (creatinine
clearance) at each of 3 measurements over 72 hours. IGF I (100
ug/kgbcutaneously every 12 hours for 6 doses) or placebo was
administered on admission to the intensive care unit immediately
post-operatively. IGF I and placebo-treated groups were well-matched
for sex, age, type of surgery, renal ischemic time during surgery
(ischemic index), baseline creatinine clearance and baseline serum
creatinine. No patient in the study developed acute renal failure
post-operatively. IGF I was well tolerated. A smaller proportion of
patients in the IGF I group had a post-operative decline in renal
function (22%) than in the placebo-treated group (33%). There were no
significant differences in levels of serum creatinine at time of
discharge, length of hospital stay, length of intensive care unit
stay, length of intubation or incidence of dialysis/death. Our
findings establish the feasibility and potential utility for the use
of IGF-I to reduce the incidence of postoperative renal dysfunction
in high-risk patients.
Received 7 June 1996; accepted in final form 28 October 1996.
APS Manuscript Number F167-6.
Article publication pending Am. J. Physiol. (Renal Fluid Electrolyte
Physiology).
ISSN 1080-4757 Copyright 1996 The American Physiological Society.
Published in APStracts on 13 November 1996