Therapeutic Trials Of Insulinlike Growth Factor I In Humans

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FIGURE 17-21

Summary of an abstract describing the trial of insulin-like growth factor (IGF-I) in the treatment of patients with established acute renal failure (ARF). Based on the accumulated animal and human data, a multicenter, double-blind, randomized, placebo-controlled trial was performed to examine the effects of IGF-I in patients with established ARF. Enrolled patients had ARF of a wide variety of causes, including surgery, trauma, hypertension, sepsis, and nephro-toxic injury. Approximately 75 patients were enrolled, treatment being initiated within 6 days of the renal insult. Renal function was evaluated by iodothalimate clearance. Unfortunately, at an interim analysis (the study was originally designed to enroll 150 patients) there was no difference in renal function or survival between the groups. The investigators recognized several potential problems with the trial, including the severity of many patients' illnesses, the variety of causes of the renal injury, and delay in initiating therapy [4].

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Insulin-dependent and non-insulin-dependent diabetes mellitus Acute renal failure Chronic renal failure

FIGURE 17-22

Advantages of insulin-like growth factor (IGF-I) in the treatment of acute renal failure. The limited data obtained to date on the use of IGF-I for acute renal failure demonstrate that the peptide is well-tolerated and may be useful in selected patient populations. Additional human trials are ongoing including use in the settings of renal transplantation and chronic renal failure.

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