Multicenter clinical trial of recombinant human insulin-like growth factor I in patients with acute renal failure

Methods. Our objective was to determine whether injections there were no differences in the changes from baseline values of recombinant human IGF-I (rhIGF-I) would enhance the recovery of renal function and is safe in patients with ARF. The of the glomerular filtration rate, creatinine clearance, daily study was designed as a randomized, double-blind, placebo- urine volume, or serum urea nitrogen, creatinine, albumin or controlled trial in intensive care units in 20 teaching hospitals. transferrin. In patients who did not receive renal replacement Seventy-two patients with ARF were randomized to receive therapy, there was also no significant difference in serum creatirhIGF-I (35 patients) or placebo (37 patients). The most com- nine and urea between the two groups. Twenty patients in mon causes of ARF in the rhIGF-I and placebo groups were, the rhIGF-I group and 17 placebo-treated patients underwent respectively, sepsis (37 and 35% of patients) and hypotension dialysis or ultrafiltration. Twelve rhIGF-I‐treated patients and or hemodynamic shock (42 and 27% of patients). At baseline, 12 placebo-treated patients died during the 28 days after the the mean (6 sd) APACHE II scores in the rhIGF-I and pla- onset of treatment. cebo-treated groups were 24 6 5 and 25 6 8, respectively. In Conclusions. rhIGF-I does not accelerate the recovery of the rhIGF-I and placebo groups, the mean (median) urine renal function in ARF patients with substantial comorbidity. volume and urinary iothalamate clearances (glomerular filtration rate) were 1116 6 1037 (887) and 1402 6 1183 (1430) ml/24 hr and 6.4 6 5.9 (4.3) and 8.7 6 7.2 (4.4) ml/min and Acute renal failure (ARF) is a common event in hospidid not differ between the two groups. Patients were injected subcutaneously every 12 hours with rhIGF-I, 100 mg/kg desir- talized patients, particularly in those requiring intensive care [1]. It is associated with an increased risk for morbidity and mortality. The mortality rate in patients with