Serum concentrations and peritoneal loss of growth hormone and growth-hormone-binding protein activity in older adults undergoing continuous ambulatory peritoneal dialysis: comparison with haemodialysis patients and normal subjects.

Serum concentrations and peritoneal losses of growth hormone (GH) and of growth-hormone-binding protein (GH-BP) activity in 13 patients undergoing continuous ambulatory peritoneal dialysis (CAPD) were compared with those of 13 patients on haemodialysis and 13 normal subjects. The individuals in the three groups were matched by age (40-83 years), gender, and serum glucose concentration. In addition CAPD and haemodialysis patients were matched by haematocrit, serum creatinine and albumin concentrations, and period of time on dialysis (0.5-127 months). GH in the serum and in the peritoneal effluent were measured by radioimmunoassay (RIA) and NB2 bioassay. GH-BP activity was analysed by binding assay and expressed as a percentage of the specific binding of GH. In the haemodialysis patients, serum GH was significantly greater and serum GH-BP activity significantly less than in the CAPD patients and control subjects. Between the two latter groups no significant differences in GH or in GH-BP activity were observed. GH bioactive/immunoactive ratios in the three groups were similar. Both GH and GH-BP were detected in the peritoneal effluent of CAPD patients, in whom an overnight (8-h) peritoneal loss of GH (8.0 +/- 1.4 x 10(-3) micrograms/h/1.73 m2) was strongly correlated with serum GH (r = 0.840). Circulating GH and GH-BP activity were influenced by serum creatinine and haematocrit. In addition a positive relationship was observed between GH-BP activity and body mass index and between GH and time on dialysis. These data reaffirm that older adults undergoing haemodialysis, unlike CAPD patients, exhibit persistent abnormalities in GH-GH-BP axis.(ABSTRACT TRUNCATED AT 250 WORDS)