title: Use of nandrolone decanoate as an adjuvant for erythropoietin dose reduction in treating anemia in patients on hemodialysis.
abstract: 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.
authors.affiliation: Nephrology Unit, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Hussein
authors.initials: H
authors.lastname: Sheashaa
authors.forename: Waleed
authors.initials: W
authors.lastname: Abdel-Razek
authors.forename: Amr
authors.initials: A
authors.lastname: El-Husseini
authors.forename: Amal
authors.initials: A
authors.lastname: Selim
authors.forename: Nabil
authors.initials: N
authors.lastname: Hassan
authors.forename: Tarek
authors.initials: T
authors.lastname: Abbas
authors.forename: Hassan
authors.initials: H
authors.lastname: El-Askalani
authors.forename: Mohamed
authors.initials: M
authors.lastname: Sobh
mesh_terms: 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
chemical_list: D045930:Anabolic Agents; D004921:Erythropoietin; D009277:Nandrolone; D000077603:Nandrolone Decanoate