Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2025 May 6;28(3):56.
doi: 10.1007/s11102-025-01520-5.

Kidney function in acromegaly: evidence from a long-term observational study

Giona Castagna  1   2 , Silvia Ippolito  1 , Sara Cassibba  1 , Liana Cortesi  1 , Emanuele Costi  3 , Ahmad Harb  2 , Luigi Alberto Lanterna  3 , Angelo Mirco Sicignano  3 , Roberto Trevisan  4   5 , Alessandro Rossini  1
Affiliations
Observational Study

Kidney function in acromegaly: evidence from a long-term observational study

Giona Castagna et al. Pituitary. .

Abstract

Purpose: Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) are critical regulators of renal development and function. Acromegaly, characterized by chronic GH hypersecretion, leads to renal hypertrophy and glomerular hyperfiltration. While immediate treatment of acromegaly mitigates hyperfiltration, the long-term risk of renal damage in treated patients remains unclear. Our study aimed to assess renal function over time in patients with acromegaly who were followed long-term at our institution.

Methods: This study analyzed 80 patients with acromegaly from a single center. Creatinine values were recorded to assess kidney function before and after treatment. The estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI 2021 formula. eGFR variations were evaluated over the first 12 months after treatment (acute slope) and during long-term follow-up with a mean duration of 11.28 years (chronic slope). Descriptive statistics and multivariable regression analyses were performed.

Results: Among the 80 patients (43.7 years, 46 male), 51 underwent surgery (11 of whom also received subsequent radiotherapy), while 29 received exclusively medical therapy. Comorbidities included diabetes (31.25%) and hypertension (65%). eGFR decreased acutely after treatment in all groups, with a more pronounced decline in surgically treated patients (mean - 15.15 mL/min/1.73 m²; p = 0.042). The mean chronic eGFR loss was - 1.28 mL/year, with age (OR 1.09 per year) and diabetes (OR 5.66) significantly associated with a greater decline in eGFR (p < 0.01).

Conclusions: Renal hyperfiltration in acromegaly tends to normalize following treatment, with a more rapid response observed in patients who undergo surgery. Chronic kidney disease is highly prevalent in acromegaly and is closely linked to diabetes, which further contributes to the increased cardiovascular risk seen in these individuals.

Keywords: Acromegaly; CKD; GH; IGF-1; Kidney; eGFR.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethical approval: Data collection and analysis were approved by an appropriate Institutional Review Board of the local ethical committee. The study was performed in accordance with the Helsinki Declaration of 1964 (and its later amendments) and Good Clinical Practice Guidelines and agreed with national regulations. Consent to participate/publish: Informed consent was obtained from all individual participants for both participation in the study and publication of the results.

Figures

Fig. 1
Fig. 1
Histogram illustrating the distribution of patients across CKD stages at baseline and at study censoring, depicting the associated chronic loss of eGFR (in mL/min/1.73 m²) for each CKD stage. * Mean chronic loss of our population was compared to a longitudinal study of renal function in healthy subjects [7]. ** Prevalence of CKD in our population was compared to a pooled meta-analysis assessing prevalence of CKD in general population [16]
See this image and copyright information in PMC

References

    1. Kamenicky P, Mazziotti G, Lombes M, Giustina A, Chanson P (2014) Growth hormone, insulin-like growth factor-1, and the kidney: pathophysiological and clinical implications. Endocr Rev 35(2):234–281 - PubMed
    1. Fujio S, Takano K, Arimura H, Habu M, Bohara M, Hirano H et al (2016) Treatable glomerular hyperfiltration in patients with active acromegaly. Eur J Endocrinol 175(4):325–333 - PubMed
    1. Kirsch N, Chang LS, Koch S, Glinka A, Dolde C, Colozza G et al (2017) Angiopoietin-like 4 is a Wnt signaling antagonist that promotes LRP6 turnover. Dev Cell 43(1):71–82 e6 - PubMed
    1. Bostan H, Kizilgul M, Calapkulu M, Kalkisim HK, Topcu FBG, Gul U et al (2024) The prevalence and associated risk factors of detectable renal morphological abnormalities in acromegaly. Pituitary 27(1):44–51 - PubMed
    1. Hong S, Kim KS, Han K, Park CY (2023) A cohort study found a high risk of end-stage kidney disease associated with acromegaly. Kidney Int 104(4):820–827 - PubMed

Publication types

Substances

LinkOut - more resources