IGF1 and chronic kidney disease: Suggested mechanisms of GH resistance in such conditions are reduced density of GH receptors in target tissues as indicated by low GHBP in children and adults with chronic kidney disease (CKD), which is proportionate to the degree of renal dysfunction (69), disturbed GH-activated post-receptor Janus kinase/signal transducer, and activator of transcription (JAK/STAT) signaling (70), and decreased levels of free IGF-1 due to increased inhibitory IGF-binding proteins (IGFBPs) (71).