To evaluate the possible role of the kidney in the enhanced metabolic clearance rate (MCR) of growth hormone (GH) in obesity, we studied the kinetics of GH and renal fractional extraction of GH (RFEGH) in twelve male hypertensive patients over a wide range of body weights (range 71.7 to 129 kg), while undergoing contrast angiography on suspicion of renal artery stenosis.

A continuous infusion of recombinant human GH was administered during a continuous infusion of somatostatin to suppress endogenous GH secretion. After 2 h of GH infusion, when plasma GH had reached a steady-state at concentrations that were still in the physiological range, blood was sampled from the left and right renal artery and vein for determination of GH levels. Subsequently, the infusion of GH was stopped, and GH kinetics were investigated with noncompartmental analysis.

In none of the patients hemodynamically significant renal artery stenosis was present. Whole body MCR of GH averaged 375 ± 142 mL/min. Average GH levels were significantly higher in arterial plasma than in simultaneously sampled renal venous plasma (P < 0.001). RFEGH amounted 8.6 ± 6.8%. Both the MCR of GH and RFEGH correlated significantly with body weight, body fat mass, and endogenous creatinine clearance. Renal uptake of GH per 100 gram of kidney tissue correlated inversely with MCR. These results suggest that RFEGH rises with increasing adiposity, but per unit of renal mass the capacity of the kidney to remove GH from the circulation falls at high MCR values.