Advances in anabolic interventions for malnourished dialysis patients.
Malnutrition is a frequent state during maintenance dialysis. Among a variety of reasons, chronic catabolic events as well as resistance to anabolic compounds do induce an imbalance in protein metabolism and favor a chronic loss in protein mass. Anabolic effects have been obtained in pilot studies with recombinant growth hormone and insulin-like growth factor-1 in adult dialysis patients. More recently, the come back of androgen therapy provided reports of a positive impact on body composition and physical activity during maintenance dialysis. Strong improvement in nutritional status has also been obtained by more frequent dialysis sessions, either during long nocturnal or short daily schedules. Thus, promising new therapies are emerging to fight the important incidence of malnutrition in dialysis patients.
Fouque
Denis
D
Department of Nephrology and Research Center for Human Nutrition, Hôpital Edouard Herriot, Lyon, France. denis.fouque@chu-lyon.fr
Guebre-Egziabher
Fitsum
F
Laville
Maurice
M
D000728:Androgens / Q000627:therapeutic use; D001823:Body Composition; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D009043:Motor Activity; D009748:Nutrition Disorders / Q000209:etiology / Q000628:therapy*; D014176:Protein Biosynthesis; D011506:Proteins / Q000378:metabolism; D006435:Renal Dialysis
D000728:Androgens; D011506:Proteins; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I