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February 1978

Abnormalities in the Regulation of Growth Hormone in Chronic Renal Failure

Author Affiliations

From the Divisions of Kidney Disease and Metabolism, Department of Medicine, University of Utah College of Medicine, and the VA Hospital, Salt Lake City.

Arch Intern Med. 1978;138(2):267-271. doi:10.1001/archinte.1978.03630260061018

Carbohydrate intolerence is a common abnormality in patients with chronic renal failure. In this group of patients we investigated the interrelation among glucose, insulin, and growth hormone and confirmed the presence of carbohydrate intolerance and hyperinsulinemia. In addition we demonstrated alterations in growth hormone regulation, characterized by (1) the lack of suppression of growth hormone by orally induced hyperglycemia and paradoxical increase in serum levels of growth hormone after the administration of intravenous glucose or glucagon; (2) lack of release of growth hormone with induced hypoglycemia and an exaggerated response to levodopa administration. Furthermore, thyrotrophin-releasing hormone stimulated growth hormone release, a phenomenon not observed in the control population. Our studies show an impaired hypothalamic regulation of growth hormone secretion in patients with renal failure undergoing long-term hemodialysis.

(Arch Intern Med 138:267-271, 1978)