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NDT Advance Access published online on November 9, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfp576
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© The Author 2009. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Bioactive rather than total IGF-I is involved in acute responses to nutritional interventions in CAPD patients

Michael P. Brugts, Hoey Lan Tjiong, Trinet Rietveld, Josias L. Wattimena, Jacobus W. van den Berg, Marien W. Fieren and J.A.M.J.L. Janssen

Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands

Correspondence and offprint requests to: JAMJL Janssen; Email: j.a.m.j.l.janssen{at}erasmusmc.nl



  Abstract

Background. Inadequate food intake plays an important role in the development of malnutrition in continuous ambulatory peritoneal dialysis (CAPD) patients.

Aim of the study. The aim of the study was to investigate in CAPD patients whether circulating insulin-like growth factor-I (IGF-I) bioactivity may offer a more sensitive index to acute nutritional interventions than total IGF-I.

Methods. An open-label, randomized, crossover study of 2 days—with a 1-week interval—was performed in 12 CAPD patients in the fed state to compare a mixture of amino acids (Nutrineal 1.1%) plus glucose (AA plus G) (Physioneal 1.36% to 3.86%) dialysate versus G only as control dialysate. Fed-state conditions were created by identical liquid hourly meals. IGF-I bioactivity was measured by the kinase receptor activation assay (IGF-I KIRA); total IGF-I was measured by immunoassay.

Results. In the fed state, both after AA plus G as well as after G dialysis IGF-I bioactivity increased compared to baseline, while no changes in circulating total IGF-I levels were observed in both treatment arms. However, the increase in IGF-I bioactivity was only significant after AA plus G dialysis (P = 0.02).

Conclusions. Our results provide evidence that in CAPD patients changes in circulating IGF-I bioactivity are associated with nutrient intake and that IGF-I bioactivity rather than total IGF-I is involved in acute responses to nutritional interventions in CAPD patients.

Keywords: CAPD; IGF-I bioactivity; nutrition; total IGF-I

Received for publication: 30. 7.09
Accepted in revised form: 5.10.09


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