Anabolic Steroids and Malnutrition in Chronic Renal Failure

Soliman, Gamal Abdelhakeem Mohamed; Oreopoulos, Dimitrios G.

doi:10.1177/089686089401400409

Cited by 21 publications

(4 citation statements)

References 29 publications

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“…There is interest in the potential value of anabolic steroids for the treatment of this problem. Soliman and Oreopoulos (19) published a review of the literature dealing with anabolic steroids given to patients with acute or chronic renal failure and concluded that some patients had experienced nutritional benefit from androgen administration. They argued that anabolic steroids should be evaluated more carefully for the treatment of malnutrition.…”

Section: Anabolic Steroids and Nutrition In Chronicmentioning

confidence: 99%

Use of Androgens in Patients with Renal Failure

Johnson

2000

Seminars in Dialysis

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Anabolic steroids have been used for the treatment of the anemia of chronic renal failure for more than 25 years. Due to concerns over adverse effects, their use historically has been limited to nandrolone decanoate given to men, usually over age 50, who have intact kidneys. The introduction of epoetin alfa in 1989 has led to reduced androgen use for the treatment of anemia. Nevertheless, there continues to be scientific investigation into the possible role that androgens may play in combination with or as an alternative to erythropoietin. Whether combination therapy will prove to be useful remains to be determined in a large, prospective, randomized trial. There is little likelihood, based on present literature, that androgen therapy alone will replace epoetin alfa in U.S. dialysis units. This topic was addressed recently by the Anemia Work Group of the National Kidney Foundation Dialysis Outcomes Quality Initiative (27). While acknowledging androgen treatment may be less expensive than epoetin alfa, the group stated that the potential risks of primary androgen therapy alone make this form of treatment "unacceptable." The work group did not offer any recommendations on the combined use of erythropoietin and androgens, stating that published data are inconclusive. If future reimbursement policies are changed to include epoetin alfa within a capitated rate, economic incentives may lead to increased use of androgens to achieve targeted hematocrit values. The potential value of anabolic steroids for treating malnutrition in dialysis patients is an intriguing idea. Very little has been done to explore this issue, and this clinical practice has not become widespread nor universally recommended (28). Prospective clinical trials in this area may be warranted as well.

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Section: Anabolic Steroids and Nutrition In Chronicmentioning

confidence: 99%

Use of Androgens in Patients with Renal Failure

Johnson

2000

Seminars in Dialysis

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“…Androgenic steroids, such as nandrolone decanoate, have improved nutritional parameters through their anabolic effects, hence increasing lean body mass and improving nitrogen balance. [39][40][41] Recombinant human growth hormone has well-established anabolic properties. It promotes protein synthesis, decreases protein degradation, enhances lipolysis, and increases food conversion.…”

Section: Anabolic Agentsmentioning

confidence: 99%

“…45 Based on several preliminary studies, the use of anabolic steroids and growth factors for treatment of malnutrition may be promising. [39][40][41][46][47][48][49][50] However, whether use of these agents will result in long-term improvement in nutritional indexes, morbidity, and mortality must be clarified by further studies.…”

Section: Anabolic Agentsmentioning

confidence: 99%

Malnutrition in Patients Undergoing Hemodialysis: Is Intradialytic Parenteral Nutrition the Answer?

How

Lau

2004

Pharmacotherapy

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Patients with end-stage renal disease often experience malnutrition as a result of decreased dietary intake; inadequate dialysis; loss of nutrients into the dialysate; abnormal protein, carbohydrate, and lipid metabolism; and concomitant diseases, which may contribute to an increase in morbidity and mortality. Intradialytic parenteral nutrition (IDPN) is being used to improve nutritional status, in conjunction with other methods of nutritional supplementation. The biggest advantage of IDPN is probably its convenience since it is administered during dialysis treatment and thus does not require additional clinic visits or prolonged dialysis time. Although IDPN has several disadvantages, its ability to improve nutritional status and reduce morbidity and mortality in patients with end-stage renal disease is promising. Well-designed, large-scale, prospective studies are required to confirm its beneficial effects.

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“…Several studies have recently shown that admin istration of recombinant human growth hormone (rHGH) or insulinlike growth factor-1 (IGF-1) can improve nutritional parameters (for example, increased serum albumin, transferrin) (8,16,70,71). However, use of these hormones is still in the experimental stage.…”

Section: Prevention and Treatment Of Malnutritionmentioning

confidence: 99%