OBJECTIVE: To observe the variation of GH2IGF axis in children with the refractory nephrotic syndrome (RNS) . METHODS:  Serum and urine levels of IGF2I and IGFBP23 and baseline serum levels of GH were assayed using
RIA and IRMA in 26 patients with RNS , and hight standard deviation score (HtSDS) was calculated. Eighteen healthy children of similar ages were used as the control group (NC group) . RESULTS:　Serum IGF2I [ (152. 68 ±120. 95) ng/ ml ] and IGFBP23 [ (2 183. 33 ±1 711.33) ng/ ml ] levels in the RNS group were significantly lower than those of the NC group [ (255. 68 ±46. 92) ng/ ml, 4 333.87 ±1 122.00) ng/ ml ] (P<0.05), and urine IGF2I [ (5. 32 ±2. 84) ng/ mg creatinine ] and IGFBP23 [ (16. 38 ±8. 55) ng/ mg creatinine ] levels were higher than those of the NC group [ (0.90 ±0.37) ng/ mg creatinine, (5.13 ±1. 64) ng/ mg creatinine ] ( P<0.05). The serum GH level was lower than that of the NC group, but didn’t achieve any statistical significance. HtSDS (-0.42±0.75) of the RNS group was lower than that of the NC group (0.30±0.17) (P<0.05). CONCLUSIONS:　A disorder of the GH2IGF axis was detected in children with RNS. This abnormality may contribute to the growth failure seen in RNS.