Treatment of acute renal failure with insulin-like growth factor-I

Despite numerous progresses, including extracorporeal epuration, acute renal failure (ARF) remains associated with a high level of mortality and morbidity, particularly in intensive care unit. Experimental research on different acute renal failure models has clearly shown that growth factors and particularly Insulin-like Growth Factor I (IGF-I) can reduce renal injury, improve renal recovery and even reduce mortality. IGF-I, that is locally produced in injured renal tubules, promotes the proliferation and differentiation of new tubular cells. Moreover, IGF-I carriers (IGFBPs) and IGF-I receptor are altered in ARF and modify the growth factor bioactivity. To date, only two clinical trials studied IGF-I treatment in the ARF condition. Other studies are required to demonstrate a role for IGF-I in treating or preventing acute renal failure.