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[Insulin-like growth factor 1 in patients with multiple organ dysfunction during hemofiltration/hemodiafiltration].

Severe diseases of different etiology are generally accompanied by significant neurohumoral stress and catabolism. The use of insulin and insulin-like growth factor 1 (IGF-1) regulates the rate of protein and carbohydrate catabolism, retards increasing azotemia, thus normalizing protein metabolism. By taking into account the physicochemical properties of IGF-1 and the high resolving capacity of the modes of renal replacement therapy (RRT), it cannot be ruled out the possibility that the really significant amount of this polypeptide is eliminated, which may negatively affect the patient's metabolic adaptation. In this connection, the authors studied the levels of IGF-1 in patients with multiple organ dysfunction during hemofiltration/hemodiafiltration (HF/HDF). All the patients were found to have the maximum low content of IGF-1 both before and during RRT. There was a high elimination of this hormone with an effluent during RRT. The clearance of IGF-1, calculated for 24 hours of a procedure was equal to that of the proinflammatory cytokines TNFa and IL-Ibeta during HF/HDF. The results lead to the conclusion that early replacement therapy for hypercatabolism should be performed in patients with multiple organ dysfunction.