Renal effects of growth hormone in health and in kidney disease.
Renal effects of growth hormone in health and in kidney disease.
复制标题
生长激素在健康和肾脏疾病中的肾作用。
DOI：
10.1007/s00467-021-05097-6
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Leifheit-Nestler M
中科院分区：
文献类型：
--
作者：
Haffner D;Grund A;Leifheit-Nestler M
生长激素(GH)及其介体胰岛素样生长因子-1(IGF-1)对肾脏有多种作用。GH和IGF受体在肾脏中大量表达，包括肾小球和肾小管上皮细胞。GH可以直接作用于肾脏，也可以通过循环或旁分泌合成的IGF-1发挥作用。GH/IGF-1系统调节肾小球血流动力学、肾脏糖异生、肾小管钠水、磷酸盐和钙的处理，以及肾脏1，25(OH)2维生素D3和抗衰老激素Klotho的合成。后者也是近端小管中磷酸尿激素成纤维细胞生长因子23的共同受体。重组人生长激素(RhGH)被广泛用于治疗儿童矮小，包括慢性肾脏疾病(CKD)。动物研究和对肢端肥大症患者的观察表明，GH过量可对肾脏健康产生有害影响，包括肾小球高滤过、肾肥大和肾小球硬化。此外，控制不佳的1型糖尿病患者的GH升高被认为是导致足细胞损伤，从而促进糖尿病肾病的发生。本文综述了GH/IGF-1对肾脏的生理作用，以及GH/IGF-1系统的多种改变及其在肢端肥大症、慢性肾脏病、肾病综合征和1型糖尿病患者中的后果。最后，我们将讨论短期和长期应用重组人生长激素/胰岛素样生长因子-1对肾脏疾病患者肾功能的影响。
Growth hormone (GH) and its mediator insulin-like growth factor-1 (IGF-1) have manifold effects on the kidneys. GH and IGF receptors are abundantly expressed in the kidney, including the glomerular and tubular cells. GH can act either directly on the kidneys or via circulating or paracrine-synthesized IGF-1. The GH/IGF-1 system regulates glomerular hemodynamics, renal gluconeogenesis, tubular sodium and water, phosphate, and calcium handling, as well as renal synthesis of 1,25 (OH)2 vitamin D3 and the antiaging hormone Klotho. The latter also acts as a coreceptor of the phosphaturic hormone fibroblast-growth factor 23 in the proximal tubule. Recombinant human GH (rhGH) is widely used in the treatment of short stature in children, including those with chronic kidney disease (CKD). Animal studies and observations in acromegalic patients demonstrate that GH-excess can have deleterious effects on kidney health, including glomerular hyperfiltration, renal hypertrophy, and glomerulosclerosis. In addition, elevated GH in patients with poorly controlled type 1 diabetes mellitus was thought to induce podocyte injury and thereby contribute to the development of diabetic nephropathy. This manuscript gives an overview of the physiological actions of GH/IGF-1 on the kidneys and the multiple alterations of the GH/IGF-1 system and its consequences in patients with acromegaly, CKD, nephrotic syndrome, and type 1 diabetes mellitus. Finally, the impact of short- and long-term treatment with rhGH/rhIGF-1 on kidney function in patients with kidney diseases will be discussed.
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影响因子：
--
作者：
BONDY, CA;WERNER, H;LEROITH, D
通讯作者：
LEROITH, D
影响因子：
8.2
作者：
Boguszewski, Margaret C. S.
通讯作者：
Boguszewski, Margaret C. S.
影响因子：
5.4
作者：
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通讯作者：
HALL, K
影响因子：
4.8
作者：
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通讯作者：
KOPCHICK, JJ
影响因子：
5.8
作者：
Chernausek, Steven D.;Backeljauw, Philippe F.;Underwood, Louis E.
通讯作者：
Underwood, Louis E.