Use of nandrolone decanoate as an adjuvant for erythropoietin dose reduction in treating anemia in patients on hemodialysis.
OBJECTIVE
Use of androgen as an adjuvant therapy to treat anemia in patients on hemodialysis is debated. Our target is to assess the safety and the efficacy of nandrolone decanoate (ND) as an effective adjunctive therapy to treat such anemia.


METHODS
This study included 32 anemic adult hemodialysis patients who had adequate iron stores. They were randomized into two equal groups: the first group received subcutaneously a low dose of erythropoietin (EPO) 1,000 U three times weekly combined with ND, 50 mg intramuscularly twice weekly, and the second group received only the same low dose of EPO for the 6-month study period. All patients were subjected to a serial follow-up of hemoglobin (Hb), hematocrit % (Hct%), iron store indices, serum insulin-like growth factor-1 (IGF-1) concentration and liver function tests.


RESULTS
A significant rise of both Hb and Hct in both groups was found at the end of the study (p < 0.001). Although the rise of both Hb and Hct was higher in the androgen group, it was not rated as being statistically significant. Both groups showed a significant rise of serum IGF-1 concentration at the end of the study in comparison to its initial value. Moreover, the androgen group attained a more statistically significant rise of IGF-1 serum concentration. Four female patients discontinued ND because of related adverse effects, principally distressing hirsutism and hepatic dysfunction.


CONCLUSIONS
Addition of ND to a low-dose EPO regimen does not offer a significant benefit. Androgen-related side effects limit its use in female patients.
Sheashaa
Hussein
H
Nephrology Unit, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Abdel-Razek
Waleed
W
El-Husseini
Amr
A
Selim
Amal
A
Hassan
Nabil
N
Abbas
Tarek
T
El-Askalani
Hassan
H
Sobh
Mohamed
M
D000328:Adult; D045930:Anabolic Agents / Q000627:therapeutic use*; D000740:Anemia / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D009277:Nandrolone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077603:Nandrolone Decanoate; D011446:Prospective Studies; D006435:Renal Dialysis
D045930:Anabolic Agents; D004921:Erythropoietin; D009277:Nandrolone; D000077603:Nandrolone Decanoate