The role of growth hormone in the pathogenesis of diabetic kidney disease.

At present, diabetic kidney disease affects about 15-20% of all Type 1 diabetic patients and 20-40% of all patients with Type 2 diabetes. Preclinical research performed over the past decade has suggested growth hormone (GH) and insulin-like growth factors (IGFs) to be involved in the pathogenesis of diabetic kidney disease. Data obtained in knock-out (KO) mice with GH receptor (GHR)/GH binding protein (GHBP) gene-disruption have shown that these animals are protected against diabetes-induced renal changes. Further, diabetic mice treated with either a longacting somatostatin analogue or a specific GHR antagonist (GHRA) showed normalization of the diabetes-associated renal hypertrophy and glomerular enlargement and most importantly also a lowering effect on the diabetes-induced rise in urinary albumin excretion (UAE), a marker of renal damage. Based on these experimental data future studies are warranted to characterize the clinical potential of GH-inhibitors (e.g. GHRAs) as drugs for the treatment of diabetic renal complications.