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- Title
Differential effects of growth hormone therapy in malnourished hemodialysis patients.
- Authors
Kotzmann, Harald; Yilmaz, Nilgün; Lercher, Piero; Riedl, Michaela; Schmidt, Alice; Schuster, Ernst; Kreuzer, Sören; Geyer, Georg; Frisch, Herwig; Hörl, Walter H.; Mayer, Gert; Luger, Anton
- Abstract
Differential effects of growth hormone therapy in malnourished hemodialysis patients. Background. Malnutrition is common in chronic hemodialysis patients and is associated with increased morbidity and mortality. Several factors such as metabolic acidosis, hyperparathyroidism, and insulin as well as growth hormone (GH) resistance may lead to enhanced protein catabolism. Recombinant human growth hormone (rhGH) has been proposed as treatment of malnutrition because of its anabolic effects. Methods. In the present placebo-controlled, double blind study, the effects of three months of rhGH therapy on nutritional and anthropometric parameters, on bone metabolism and bone mineral density (BMD), as well as on polymorphonuclear leukocyte (PMNL) function and quality of life (QoL) were evaluated in 19 malnourished hemodialysis patients (10 females and 9 males) with a mean age of 59.3 ± 13.4 years. RhGH (0.125 IU/kg) was given three times a week during the first four weeks and 0.25 IU/kg thereafter three times a week after each dialysis session. Results. Insulin-like growth factor I (IGF-I) concentration rose significantly from 169.2 ± 95.6 ng/mL to 262.9 ± 144.4 ng/mL (p< 0.01) in the group receiving rhGH. Albumin, prealbumin, transferrin, cholesterol, high-density lipoprotein (HDL) cholesterol, cholinesterase, predialytic creatinine, and blood urea nitrogen showed no significant changes during the three months in both groups. Total body fat (%TBF) was slightly reduced after three months (P = NS) in the patients receiving GH, whereas lean body mass (LBM) remained stable during therapy. Procollagen I carboxy terminal peptide (PICP), a marker of bone formation, increased significantly after three months from 250.1 ± 112.6 to 478.5 ± 235.2 μg/L (P < 0.01) in the GH-treated patients, whereas parameters of bone resorption like telopeptide ICTP showed only a slight increase (50.3 ± 18.5 vs. 70.0 ± 39.5 μg/L, P = NS). BMD at the lumbar...
- Subjects
SOMATOTROPIN; HEMODIALYSIS patients; SOMATOMEDIN; NEUTROPHILS; THERAPEUTICS
- Publication
Kidney International, 2001, Vol 60, Issue 4, p1578
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1046/j.1523-1755.2001.00971.x