IGF1 and acromegaly: Increased GH, IGF-1, increased renal hyperfiltration and excessive Na absorption in acromegaly patients lead to an increase in renal size and an increase in HT frequency.[21] A study in acromegaly patients reported that kidney sizes and urinary ACR levels were higher in the active disease group than in the control group.[6] In our study, both acute renal size and urinary ACR levels were higher in patients with acromegaly with active disease, similar to the previous study.