Short-term effects of recombinant human growth hormone in CAPD patients.
Protein and calorie malnutrition is common in chronic dialysis patients. Several interventions have been proposed to prevent and/or to treat malnutrition. Recombinant human growth hormone (rhGH) is a drug with anabolic properties and has been used in several catabolic conditions, such as patients with severe burns as well as in pediatric patients with chronic renal failure. In this study, we evaluated the short-term effects and safety of rhGH on urea kinetics and commonly measured biochemical parameters in 10 stable adult continuous ambulatory peritoneal dialysis (CAPD) patients. The design of the study was prospective, cross-over with the patients serving as their own controls. There were three study periods: baseline (PreGH), treatment (Tx), and follow-up (PostGH). During the seven day Tx period, patients self-administered 5 mg/day s.c. of rhGH. During this time, there was a significant decrease in blood urea nitrogen (BUN) (54 +/- 15 to 40 +/- 12 mg/dl), as well as in the combined dialysate and urine urea nitrogen excretion rate (5.69 +/- 1.86 to 4.04 +/- 1.13 g/day), and protein catabolic rate (0.82 +/- 0.13 to 0.67 +/- 0.09 g/kg/day), (all P < 0.001). Serum phosphorus (4.8 +/- 1.6 to 4.4 +/- 1.8 mg/dl) and potassium (4.0 +/- 0.4 to 3.6 +/- 0.2 mEq/liter) levels also showed a small but statistically significant decrease, in conjunction with a statistically significant increase in serum creatinine levels (12.2 +/- 5.7 to 12.9 +/- 5.7 mg/dl). Dietary protein intake, determined by dietary recall, did not change during the study (66.1 +/- 20.5 vs. 75.8 +/- 22.1 grams/day).(ABSTRACT TRUNCATED AT 250 WORDS)
Ikizler
T A
TA
Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Wingard
R L
RL
Breyer
J A
JA
Schulman
G
G
Parker
R A
RA
Hakim
R M
RM
D000328:Adult; D001806:Blood Urea Nitrogen; D018592:Cross-Over Studies; D005260:Female; D013006:Growth Hormone / Q000494:pharmacology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D011228:Prealbumin / Q000378:metabolism; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000097:blood / Q000188:drug therapy / Q000517:prevention & control*; D011994:Recombinant Proteins / Q000627:therapeutic use; D013997:Time Factors; D014168:Transferrin / Q000378:metabolism
D011228:Prealbumin; D011994:Recombinant Proteins; D014168:Transferrin; D013006:Growth Hormone