title: Megestrol acetate improves weight gain in pediatric patients with chronic kidney disease.
abstract: OBJECTIVE
  Megestrol acetate (MA) has been used to treat weight loss in pediatric patients with malignancies, cystic fibrosis and HIV/AIDS. We herein report our experience with MA in pediatric patients with chronic kidney disease (CKD).
  
  
  METHODS
  We conducted a retrospective cohort study. Charts were evaluated for clinical, treatment, and laboratory data at six time points: approximately 6 months prior to initiation of MA, at initiation and cessation of MA, and at 2-, 4-, and 8-month follow-up. Anthropometric measurements were corrected for age and sex by conversion to z scores.
  
  
  METHODS
  Division of Pediatric Nephrology, Helen DeVos Children's Hospital, Grand Rapids, MI.
  
  
  METHODS
  Pediatric patients (n = 25) with CKD and poor weight gain.
  
  
  METHODS
  Patients were administered MA at initial and tapered doses of 14.4 ± 8.1 mg/kg/d and 10.1 ± 6.5 mg/kg/d, respectively, for 5.4 ± 6.3 months.
  
  
  RESULTS
  The study population (n = 25) was 60% male, 16% African American, 72% white, and 12% Hispanic with a mean ± SD age of 8.9 ± 5.4 years. Prior to MA therapy, patients demonstrated a decrease in BMI and poor weight gain. The treatment phase was associated with significant increases in BMI (P < .0001) and weight (P < .0001), which were well sustained at 8-month follow-up (P < 0.01 and P < 0.001, respectively). Patients demonstrated continued increases in height. A single patient exhibited physical adverse side effects (cushingoid features) associated with MA; otherwise, MA was well tolerated.
  
  
  CONCLUSIONS
  MA appears to effectively improve weight gain in pediatric CKD patients with minimal adverse side effects and may therefore serve as a safe, short-term, nutritional strategy.
authors.affiliation: Pediatric Nephrology, Dialysis and Transplantation, Helen DeVos Children's Hospital and Michigan State University College of Human Medicine, Grand Rapids, MI 49503, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Hobbs
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Bunchman
authors.forename: David P
authors.initials: DP
authors.lastname: Weismantel
authors.forename: Morgan R
authors.initials: MR
authors.lastname: Cole
authors.forename: Karen B
authors.initials: KB
authors.lastname: Ferguson
authors.forename: Tracy R
authors.initials: TR
authors.lastname: Gast
authors.forename: Gina-Marie
authors.initials: GM
authors.lastname: Barletta
mesh_terms: D000293:Adolescent; D019167:Appetite Stimulants / Q000627:therapeutic use*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000473:pathology*; D008297:Male; D019290:Megestrol Acetate / Q000627:therapeutic use*; D012189:Retrospective Studies; D015430:Weight Gain; D015431:Weight Loss; D055815:Young Adult
chemical_list: D019167:Appetite Stimulants; D019290:Megestrol Acetate