Endocrine Abstracts

Introduction: Acromegaly is a rare disease resulting from GH excess mostly due to pituitary adenomas. It is associated with changes of most organ systems and multiple comorbidities. The impact of GH and IGF-I excess on renal function in acromegaly is unclear.

Methods: We investigated 66 acromegalic patients from our outpatient clinic (32 female, 34 male, mean age 61.5±12.9 years, women 10 years older than men). The renal function was assessed by blood and urine tests, ultrasound and blood-gas analysis.

Results: 38 patients were considered biochemically controlled according to latest recommendations on criteria for cure of acromegaly (IGF-I in age- and gender-specific reference range, random basal GH <1 ng/ml). 12 patients were partially controlled (IGF-I up to 1.3 times elevated), 16 biochemically active. 61% of the patients have hypertension (68% of the controlled, 75% of the partially and 31% of the uncontrolled patients), 21% of the patients presented with diabetes mellitus, 11% have both. The distribution between the sexes was balanced. According to the Cystatin C formula (GFR(CysC)=77.24×Cystatin C^−1,2623) 39 patients (59%) presented with reduced glomerular filtration rate (GFR < 90 ml/min). 50% of the patients have a chronic kidney disease stage 2 (GFR 60–89 ml/min), 9% stage 3 (GFR 30–59 ml/min). Despite their higher age the median GFR of the female patients is 4 ml/min higher (82.4 vs 86.4 ml/min). The median GFR of hypertonic patients is 21.6 ml/min lower than in patients without hypertension (80.8 vs 102.4 ml/min). There is no significant difference between the GFR of controlled, partially and not controlled patients in our patients (81.9 vs 89.5 vs 84.1 ml/min).

Conclusion: We found a reduced renal function (GFR <90 ml/min) in 59% of acromegalic patients. The disease activity has no effect on GFR as determined by Cystatin C formula.