Rapid Publication Recombinant Human Insulin-like Growth Factor-I Accelerates Recovery and Reduces Catabolism in Rats with Ischemic Acute Renal Failure

This study evaluated whether recombinant human insulin-like growth factor-I (rhIGF-I) enhances recovery of renal function and reduces catabolism in rats with ischemic acute renal failure (ARF). ARF and sham rats received subcutaneous injections of either rhIGF-I or vehicle three times daily starting 5 h after surgery. Serum creatinine and urea, which initially rose simi-larly in the ARF + vehicle and ARF + rhIGF-I rats, increased more slowly after commencing the rhIGF-I injections. 72 h after surgery, the ARF + rhIGF-I rats, in comparison with ARF + vehicle animals, showed significantly greater renal plasma flow and filtration fraction, a fivefold higher glomerular filtration rate, greater renal cortical IGF-I levels, increased proliferating cell nuclear antigen expression in proximal tubule nuclei and enhanced DNA synthesis in the renal cortex, corti-comedullary junction, glomeruli, and tubules as demonstrated by I3HIthymidine incorporation and in corticomedullary junc-tion tubules as determined by autoradiography. Estimated total nitrogen output (ETNO) was greater in ARF + vehicle than in ARF + rhIGF-I or sham rats throughout the study. ETNO in ARF + rhIGF-I rats returned to sham values by the second day after surgery. 72 h after surgery, protein degradation was in-creased and protein synthesis reduced in the epitrochlearis muscle of ARF + vehicle as compared with ARF + rhIGF-I or sham + vehicle rats. Thus, treatment with rhIGF-I starting 5 h after inducing ischemic ARF in rats increases recovery of renal function, enhances formation of new renal tubular cells, lowers protein degradation, and increases protein synthesis in skeletal muscle and reduces net catabolism. (J. Clin. Invest. 1993. 91:2281-2287.) Key words: acute renal failure * glomerular fil-tration rate * insulin-like growth factor-I * mitosis * muscle pro-tein metabolis