Renal Function Following Hypophysectomy in Man

Falkheden, Thomas

doi:10.1530/acta.0.0420571

Cited by 33 publications

(9 citation statements)

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“…These data are consistent with the thesis that the low ERPF and GFR in GH deficiency is due to the lack of synthesis of IGF I rather than the deficiency in GH per se. The data are also consistent with a stimulatory effect of IGF I on ERPF and GFR.Renal plasma flow (RPF) and glomerular filtration rate (GFR) are known to be low in growth hormone (GH)-deficient patients as compared to normal adults even when values are corrected for body surface area [ 1,2], In contrast, RPF and GFR are elevated in acromegal ics and fall rapidly after hypophysectomy, before a de crease in kidney size can be demonstrated [3,4], From these observations it has been inferred that GH may increase RPF and GFR. However, a short-term intrave nous infusion of GH failed to increase renal hemody namics in normal subjects [5], whereas repetitive daily intramuscular injections of GH for several days in nor mals [6,7] and hypopituitary patients [8] resulted in a significant rise in RPF and GFR.…”

supporting

confidence: 54%

Increase in Renal Plasma Flow and Glomerular Filtration Rate during Growth Hormone Treatment May Be Mediated by Insulin-Like Growth Factor I

Hirschberg

Kopple²

1988

Am J Nephrol

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The temporal relationships between the changes in inulin and p-aminohippurate clearances and plasma growth hormone (GH) and insulin-like growth factor I (IGF I) levels were examined in a man with hypothalamic GH deficiency before and during the first 6 days of treatment with daily GH injections. The patient ate a diet with a constant protein and salt content from 1 week before the study until it was completed. During the 4-hour period immediately after the first GH injection, plasma GH rose markedly, but plasma IGF I was not detectable, and effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) did not change from baseline. On the next day, before the second GH injection was given, plasma GH was only slightly elevated, plasma IGF I had increased, and ERPF and GFR had risen by +35.5 ± 2.1 % (SEM) and +22.7 ± 2.8%, respectively. On the 4th and 7th days, immediately before the GH injections, there was no further rise in ERPF and GFR, both of which remained well above baseline values. At these times, plasma GH levels were at baseline, but plasma IGF I continued to rise progressively. These data are consistent with the thesis that the low ERPF and GFR in GH deficiency is due to the lack of synthesis of IGF I rather than the deficiency in GH per se. The data are also consistent with a stimulatory effect of IGF I on ERPF and GFR.

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supporting

confidence: 54%

Increase in Renal Plasma Flow and Glomerular Filtration Rate during Growth Hormone Treatment May Be Mediated by Insulin-Like Growth Factor I

Hirschberg

Kopple²

1988

Am J Nephrol

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“…Falkheden (12) found an average increase in total vascular resistance of 30% in a group of hypophysectomized patients. Renal blood flow is reduced (14,15), and we have recently found a considerable decrease in hand blood flow.2 It seems likely that venous return and cardiac output in the hypophysectomized diabetics are reduced to such a degree that an unchanged blood pressure can be maintained only by a considerable increase in the activity of the sympathetic nervous system. The increased levels of PCA may also be due to other regulatory mechanisms than that of blood pressure.…”

Section: Methodsmentioning

confidence: 91%

Plasma Catecholamines in Long-Term Diabetics with and without Neuropathy and in Hypophysectomized Subjects

Christensen¹

1972

J. Clin. Invest.

185

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A B S T R A C T Employing a precise and sensitive double-isotope derivative technique, plasma catecholamine concentration (PCA) was measured in four groups of subjects: (a)* long-term diabetics with neuropathy, (b) long-term diabetics without neuropathy, (c) hypophysectomized long-term diabetics with neuropathy, and (d) nondiabetic control subjects. Blood samples were obtained from subjects in the supine and in the standing position.In nondiabetic control subjects, PCA (mainly noradrenaline) increased from 0.26 ng/ml in the supine position to 0.69 and 0.72 ng/ml 5 and 10 min after assuming the standing position. By plotting this increase in PCA on the y axis in a coordinate system vs. increase in pulse rate, PCA was divided into two components: one of these depended on the rise in pulse rate on standing (called CAH) and the other corresponded to the intercept on the y axis where rise in pulse rate equals zero (CAP).Long-term diabetics with neuropathy showed a significant reduction in PCA in both the supine and the standing position. Further analysis demonstrated that CAP was considerably reduced whereas CAH was normal. Long-term diabetics without neuropathy showed normal PCA values.Surprisingly, hypophysectomized diabetics with neuropathy exhibited mean PCA values in both the supine and the standing position which were similar to those found in the nondiabetic subjects and considerably elevated compared with the findings in the nonoperated, long-term diabetics with neuropathy. Further analysis in terms of CAP and CAH demonstrated, however, that CAP was just as abnormally reduced in the hypophysectomized as it was in the nonoperated patients whereas CAH was considerably increased.In contrast to the findings in the nonoperated dia-

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“…It is not clear whether growth hormone is necessary for maintaining normal lung size. Renal size and function decrease after hypophysectomy (34,35) and it may be that lung size and perhaps function also decrease in the absence of basal levels of growth hormone.…”

Section: Former Acromegalicmentioning

confidence: 99%

Acromegalic pneumonomegaly: lung growth in the adult

Brody¹,

Fisher²,

Göçmen³

et al. 1970

J. Clin. Invest.

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A B S T R A C T Lung size was evaluated with pulmonary function tests in 10 patients with acromegaly, 1 pituitary giant, and 1 patient who had acromegaly but now has hypopituitarism. In the six acromegalic men all lung volumes were increased. The average values and per cent of predicted were total lung capacity 9.1 liters, 139%; functional residual capacity 5.2 liters, 145%; vital capacity 6.0 liters, 134%; and tissue volume 1.1 liters. There was no evidence of airflow obstruction or air trapping. Anatomic dead space was increased in proportion to the large lung volumes. Lung compliance was increased, averaging 0.43 liters/cm H20, but lung elastic recoil was normal. These studies show that the lung is involved in the general visceromegaly of acromegaly and that lung size increases in acromegalic men as a result of actual lung growth. Despite the large lung volumes, diffusing capacity was normal suggesting that lung growth resulted from an increase in the size rather than from an increase in the number of alveoli. In contrast to the acromegalic men, lung volumes, anatomic dead space and tissue volume were normal in four acromegalic women, suggesting that sex hormones may modify the effect of growth hormone on the lung. Lung size was large in the pituitary giant but lung volumes were normal according to predicted values based on the patient's great height. Lung volumes were normal in the one male who had been acromegalic but who has been hypopituitary for 21 yr. The role of growth hormone in normal postnatal lung growth and in the maintainance of normal lung size remains to be defined.

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Renal Function Following Hypophysectomy in Man

Cited by 33 publications

References 0 publications

Increase in Renal Plasma Flow and Glomerular Filtration Rate during Growth Hormone Treatment May Be Mediated by Insulin-Like Growth Factor I

Increase in Renal Plasma Flow and Glomerular Filtration Rate during Growth Hormone Treatment May Be Mediated by Insulin-Like Growth Factor I

Plasma Catecholamines in Long-Term Diabetics with and without Neuropathy and in Hypophysectomized Subjects

Acromegalic pneumonomegaly: lung growth in the adult

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