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- Title
Recombinant human insulin-like growth factor-1 induces an anabolic response in malnourished CAPD patients.
- Authors
Fouque, Denis; Peng, Susy C.; Shamir, Eshan; Kopple, Joel D.
- Abstract
Recombinant human insulin-like growth factor-1 induces an anabolic response in malnourished CAPD patients. Background.Insulin-like growth factor-1 (IGF-1) is an anabolic hormone that mediates most of the growth effects of growth hormone. This study tested the hypothesis that recombinant human IGF-1 (rhIGF-1) will induce an anabolic response in malnourished patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Methods.Six CAPD patients with protein-energy malnutrition underwent nitrogen balance studies in a clinical research center for 35 days each. Throughout the study, patients were maintained on their same CAPD regimen prior to hospitalization, and were fed a constant protein and energy intake that was similar to their diet prior to hospitalization. The first 15 hospital days were a baseline period; during the subsequent 20-day period, patients were given subcutaneous injections of rhIGF-1 (100 μg/kg/12 h), except for one patient who received 50 μg/kg/12 h for the first five days, followed by 100 μg/kg/12 h for the following 15 days. Results.During the treatment with rhIGF-1, serum IGF-1 increased by about 100% (P = 0.03), and nitrogen balance became strongly positive (+2.0 g/day, P = 0.015 vs. baseline). This anabolic effect was observed within hours after commencing the rhIGF-1 treatment and was largely caused by a 20% decrease in peritoneal dialysate effluent nitrogen. There was a proportionate reduction in urine nitrogen and serum urea nitrogen. This decrease in nitrogen output was sustained during the entire 20 day of treatment with rhIGF-1. Serum phosphorus decreased significantly during the first several days of rhIGF-1 treatment, whereas serum calcium increased significantly during the rhIGF-1 treatment. Serum potassium and albumin did not change during the rhIGF-1 injections. There was no change in body weight and body composition, as assessed by anthropometry during the baseline or treatment phases of the study. Some...
- Subjects
SOMATOMEDIN; CONTINUOUS ambulatory peritoneal dialysis; SERUM albumin; PHYSIOLOGY; PATIENTS
- Publication
Kidney International, 2000, Vol 57, Issue 2, p646
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1046/j.1523-1755.2000.057002646.x