Lipids, blood pressure and bone metabolism after growth hormone therapy in elderly hemodialysis patients.
BACKGROUND
Previously we have demonstrated anabolic effects and improved functional status after growth hormone (GH)-therapy in elderly patients in chronic hemodialysis. The aim of this study is to elucidate the effects of GH-therapy on lipid profiles, blood pressure and bone metabolism.


METHODS
Twenty patients, mean age 73 years, were randomized into two groups i), growth hormone (rHuGH) therapy at a dose of 0.2 IU/kg/BW, or ii) placebo subcutaneously after each dialysis session in a scheme of 3 dialysis per week during 6 months. Two patients in the GH group died (92 and 79 years old) and 1 patient was transplanted. Ten placebo treated patients and 7 GH treated patients were evaluable.


RESULTS
The uremic lipid profile with increased triglycerides (TG), low high density lipoproteins, normal lipo-protein Apo-B and relatively low Apo-E values was changed after GH therapy. An unexpected decrease of TG and an indication of decrease of Apo-E values was noted. This differs from GH-treatment to non-uremic adults. Ambulatory 24-hr blood pressures showed a normal circadian rhythm in all patients (GH:n=7, placebo:n=7) at the start and the end of the study. Bone metabolism was increased in the GH group reflected in significant increases of the osteocalcin and telopeptide of type I collagen values. An indication of increased values of propeptide of type I procollagen did not reach statistical significance.


CONCLUSIONS
Our study of GH-therapy to elderly patients on hemodialysis demonstrated decreased triglyceride levels, no effect on 24-hr blood pressure and increased bone metabolism.
Viidas
Unni
U
Department of Nephrology, Skaraborgs Hospital, 541 85 Skövde, Sweden.
Johannsson
Gudmundur
G
Mattson-Hultén
Lena
L
Ahlmén
Jarl
J
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination; D015519:Bone Density / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D007279:Injections, Subcutaneous; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D011336:Probability; D012016:Reference Values; D006435:Renal Dialysis / Q000379:methods; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
D019382:Human Growth Hormone