Effects of Low-dose Androgen in Combination with Subcutaneous Recombinant Human Erythropoietin (r-HuEPO) on Anemia and Nutritional Parameters in Hemodialysis Patients.
- Author:
Jeong Chul SEO
1
;
Hye Young KIM
;
Yong Mo YANG
;
Won Joong JEON
;
Hyun Hee LEE
;
Kyoung Soo LEE
;
Ji Bong JEONG
;
Ki Hyeong LEE
;
Jae Ho EARM
;
Seong Su KOONG
;
Seung Taik KIM
;
Eun Jong CHA
Author Information
1. Department of Internal Medicine, Collage of Medicine, Chungbuk National University, Cheongju, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Chronic hemodialysis patients;
Low-dose erythropoietin;
Low-dose nandrolone decanoate;
Anemia;
Nutritional parameters
- MeSH:
Androgens;
Anemia*;
Anthropometry;
Cholesterol;
Erythropoietin*;
Ferritins;
Folic Acid;
Hematocrit;
Humans*;
Nandrolone;
Nutritional Status;
Prealbumin;
Prospective Studies;
Renal Dialysis*;
Transferrin;
Vitamin B 12
- From:Korean Journal of Nephrology
2001;20(1):67-74
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Recombinant human erythropoietin(r-HuEPO) is the mainstay of anemia therapy in patient with end stage renal disease(ESRD), but the use of r-HuEPO is primarily limited by its high cost. So, it encourages any strategies that potentially enhance the erythropoietic response. However, studies designed to assess whether androgens would enhance the response to r-HuEPO were inconclusive. While androgens may be less expensive and may improve several nutritional parameters, their potential adverse effects discourage usage. We carried out a prospective study to examine the effect of low-dose androgen in combination with subcutaneous r-HuEPO on anemia and nutritional paramenters in hemodialysis patients. Twenty-four hemodialysis patients with hematocrit <24% or hemoglobin <8.0g/dL were randomly assigned into two groups. Group A(n=12) received 2000U r-HuEPO subcutaneously twice a week for six months. Group B(n=12) received the same dose of r-HuEPO plus nandrolone decanoate 100mg intramuscularly biweekly. Anthropometry, albumin, cholesterol, prealbumin, and transferrin were measured as nutritional parameters. The groups showed no differences in baseline levels of the followings : Hemoglobin, hematocrit; transferrin saturation; serum ferritin; intact serum parathyroid hormon, Kt/V; vitamin B12, folate; nutritional parameters. At the completion of the study, both groups showed significant increase in hematocrit compared with baseline levels(group A 20.7+/-2.2% to 26.0+/-3.8%; group B : 21.5+/-3.5% to 30.1+/-2.8%). The mean hematocrit in group B was significantly higher than in group A after 4 month study period(p<0.05). Ten of 12 patients in group B achieved a target hematocrit of 30%, as compared with four of 12 patients in group A. Both groups didn't show significant changes in any nutritional parameters. No significant side effects of androgen were noted during this short-term study. We conclude that low-dose androgen in combination with subcutaneous r-HuEPO is effetive treatment on anemia in hemodialysis patients, but does not improve nutritional status.
