Use of Nandrolone Decanoate as an Adjuvant for Erythropoietin Dose Reduction in Treating Anemia in Patients on Hemodialysis

Abstract

Background/Aims: 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. Conclusion: 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.

The Effects of Subacute Supraphysiological Dose of Nandrolone Decanoate on Liver Enzymes and Lipid Pofiles in Rats

“…The long-term AAS use seems to modify body foundation, muscle physique and reduce fat mass in athletes [3]. In addition, ND is used to treat anemia in patients on hemodialysis [4][5][6]. Assessment exposed that an extended management of AAS remains a series injures in different organs, particularly, in liver, and causes elevation of the liver enzymes [7].…”

Nandrolone Decanoate as Anabolic Therapy in Chronic Kidney Disease: A Randomized Phase II Dose-Finding Study

“…One intervention to enhance muscle mass receiving renewed interest in nephrology is nandrolone decanoate (ND) therapy [7]. ND is a non-17α-alkylated modified androgen analogue of testosterone.…”

Pharmacologic Adjuvants to Reduce Erythropoietin Therapy Dose in Anemia of Chronic Kidney Disease and End Stage Renal Disease

“…50 The increase in Hb in the nandrolone decanoate treated group (from 7.5 to 10.4 g/dL) was not statistically different from the control group (7.3 to 10.0 g/dL). Side effects, including gynecomastia, hirsutism, menstrual irregularity, and increases in liver enzymes and triglyceride levels, were common.…”