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Article: Growth hormone treatment during hemodialysis in a randomized trial improves nutrition, quality of life, and cardiovascular risk

TitleGrowth hormone treatment during hemodialysis in a randomized trial improves nutrition, quality of life, and cardiovascular risk
Authors
Issue Date2007
PublisherAmerican Society of Nephrology. The Journal's web site is located at http://www.jasn.org
Citation
Journal Of The American Society Of Nephrology, 2007, v. 18 n. 7, p. 2161-2171 How to Cite?
AbstractNutritional markers, such as lean body mass (LBM) and serum albumin, predict outcome in dialysis patients, in whom protein-energy malnutrition is associated with increased morbidity and mortality. The metabolic effects of human growth hormone (hGH) may improve the nutritional and cardiovascular health of these patients and consequently reduce morbidity and mortality. The aim of this study was to establish clinical proof of concept of hGH treatment for the improvement of the nutritional status in adult patients who are on maintenance hemodialysis. A total of 139 adult patients who were on maintenance hemodialysis and had serum albumin levels ≤40 g/L were randomly assigned to 6 mo of treatment with placebo or 20, 35, or 50 μg/kg per d hGH. Change in LBM and serum albumin (primary outcomes), health-related quality of life, and secondary efficacy and safety parameters were monitored. The study showed that hGH treatment increased LBM significantly at all dosage levels (2.5 kg [95% confidence interval 1.8 to 3.1] versus -0.4 kg [95% confidence interval -1.4 to 0.6]; P < 0.001 for pooled hGH groups versus placebo). Serum albumin tended to increase (P = 0.076), serum transferrin (P = 0.001) and serum HDL (P < 0.038) increased, and plasma homocysteine was reduced (P = 0.029). TNF-α also tended to decrease with treatment (P = 0.134). An improvement in the Role Physical SF-36 quality-of-life subscale was observed (P = 0.042). There were no differences in clinically relevant adverse events between groups. In conclusion, hGH therapy safely improves LBM, other markers of mortality and morbidity, and health-related quality of life in adult patients who are on maintenance hemodialysis. A long-term study is warranted to investigate whether these treatment benefits result in reduced mortality and morbidity. Copyright © 2007 by the American Society of Nephrology.
Persistent Identifierhttp://hdl.handle.net/10722/77456
ISSN
2015 Impact Factor: 8.491
2015 SCImago Journal Rankings: 4.699
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorFeldtRasmussen, Ben_HK
dc.contributor.authorLange, Men_HK
dc.contributor.authorSulowicz, Wen_HK
dc.contributor.authorGafter, Uen_HK
dc.contributor.authorKar, NLen_HK
dc.contributor.authorWiedemann, Jen_HK
dc.contributor.authorChristiansen, JSen_HK
dc.contributor.authorEl Nahas, Men_HK
dc.contributor.authorSulkova, Sen_HK
dc.contributor.authorFeldtRasmussen, Ben_HK
dc.contributor.authorMadsen, Men_HK
dc.contributor.authorHannedouche, Ten_HK
dc.contributor.authorLai, KNen_HK
dc.contributor.authorHoltzman, Een_HK
dc.contributor.authorGafter, Uen_HK
dc.contributor.authorSchwartz, Den_HK
dc.contributor.authorKatzir, Zen_HK
dc.contributor.authorWeissgarten, Jen_HK
dc.contributor.authorMajdan, Men_HK
dc.contributor.authorNiemczyk, Sen_HK
dc.contributor.authorSulowicz, Wen_HK
dc.contributor.authorLee, KOen_HK
dc.contributor.authorAhlmen, Jen_HK
dc.contributor.authorEl Nahas, Men_HK
dc.contributor.authorMitra, Sen_HK
dc.contributor.authorRodger, RSCen_HK
dc.contributor.authorTapson, JSen_HK
dc.contributor.authorRustom, Ren_HK
dc.contributor.authorAyub, Wen_HK
dc.contributor.authorMikhail, Aen_HK
dc.contributor.authorThomas, Men_HK
dc.date.accessioned2010-09-06T07:32:06Z-
dc.date.available2010-09-06T07:32:06Z-
dc.date.issued2007en_HK
dc.identifier.citationJournal Of The American Society Of Nephrology, 2007, v. 18 n. 7, p. 2161-2171en_HK
dc.identifier.issn1046-6673en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77456-
dc.description.abstractNutritional markers, such as lean body mass (LBM) and serum albumin, predict outcome in dialysis patients, in whom protein-energy malnutrition is associated with increased morbidity and mortality. The metabolic effects of human growth hormone (hGH) may improve the nutritional and cardiovascular health of these patients and consequently reduce morbidity and mortality. The aim of this study was to establish clinical proof of concept of hGH treatment for the improvement of the nutritional status in adult patients who are on maintenance hemodialysis. A total of 139 adult patients who were on maintenance hemodialysis and had serum albumin levels ≤40 g/L were randomly assigned to 6 mo of treatment with placebo or 20, 35, or 50 μg/kg per d hGH. Change in LBM and serum albumin (primary outcomes), health-related quality of life, and secondary efficacy and safety parameters were monitored. The study showed that hGH treatment increased LBM significantly at all dosage levels (2.5 kg [95% confidence interval 1.8 to 3.1] versus -0.4 kg [95% confidence interval -1.4 to 0.6]; P < 0.001 for pooled hGH groups versus placebo). Serum albumin tended to increase (P = 0.076), serum transferrin (P = 0.001) and serum HDL (P < 0.038) increased, and plasma homocysteine was reduced (P = 0.029). TNF-α also tended to decrease with treatment (P = 0.134). An improvement in the Role Physical SF-36 quality-of-life subscale was observed (P = 0.042). There were no differences in clinically relevant adverse events between groups. In conclusion, hGH therapy safely improves LBM, other markers of mortality and morbidity, and health-related quality of life in adult patients who are on maintenance hemodialysis. A long-term study is warranted to investigate whether these treatment benefits result in reduced mortality and morbidity. Copyright © 2007 by the American Society of Nephrology.en_HK
dc.languageengen_HK
dc.publisherAmerican Society of Nephrology. The Journal's web site is located at http://www.jasn.orgen_HK
dc.relation.ispartofJournal of the American Society of Nephrologyen_HK
dc.titleGrowth hormone treatment during hemodialysis in a randomized trial improves nutrition, quality of life, and cardiovascular risken_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1046-6673&volume=18&spage=2161&epage=2171&date=2007&atitle=Growth+hormone+treatment+during+hemodialysis+in+a+randomized+trial+improves+nutrition,+quality+of+life,+and+cardiovascular+risken_HK
dc.identifier.emailKar, NL: knlai@hku.hken_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.authorityKar, NL=rp00324en_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1681/ASN.2006111207en_HK
dc.identifier.pmid17554147en_HK
dc.identifier.scopuseid_2-s2.0-34447293565en_HK
dc.identifier.hkuros134587en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34447293565&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume18en_HK
dc.identifier.issue7en_HK
dc.identifier.spage2161en_HK
dc.identifier.epage2171en_HK
dc.identifier.isiWOS:000248758500024-
dc.publisher.placeUnited Statesen_HK
dc.identifier.f10001097893-
dc.identifier.scopusauthoridFeldtRasmussen, B=7006339828en_HK
dc.identifier.scopusauthoridLange, M=35313971400en_HK
dc.identifier.scopusauthoridSulowicz, W=7006433786en_HK
dc.identifier.scopusauthoridGafter, U=7005491869en_HK
dc.identifier.scopusauthoridKar, NL=7402135706en_HK
dc.identifier.scopusauthoridWiedemann, J=16835368100en_HK
dc.identifier.scopusauthoridChristiansen, JS=55433177900en_HK
dc.identifier.scopusauthoridEl Nahas, M=6603663521en_HK
dc.identifier.scopusauthoridSulkova, S=7005336551en_HK
dc.identifier.scopusauthoridFeldtRasmussen, B=36338998400en_HK
dc.identifier.scopusauthoridMadsen, M=7201738827en_HK
dc.identifier.scopusauthoridHannedouche, T=7006144886en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK
dc.identifier.scopusauthoridHoltzman, E=35508124800en_HK
dc.identifier.scopusauthoridGafter, U=36339231000en_HK
dc.identifier.scopusauthoridSchwartz, D=35476540500en_HK
dc.identifier.scopusauthoridKatzir, Z=6603773583en_HK
dc.identifier.scopusauthoridWeissgarten, J=7005390565en_HK
dc.identifier.scopusauthoridMajdan, M=7006061129en_HK
dc.identifier.scopusauthoridNiemczyk, S=55400205200en_HK
dc.identifier.scopusauthoridSulowicz, W=15758461300en_HK
dc.identifier.scopusauthoridLee, KO=38163169900en_HK
dc.identifier.scopusauthoridAhlmen, J=7005681247en_HK
dc.identifier.scopusauthoridEl Nahas, M=36908667100en_HK
dc.identifier.scopusauthoridMitra, S=7403178171en_HK
dc.identifier.scopusauthoridRodger, RSC=7005797021en_HK
dc.identifier.scopusauthoridTapson, JS=7005126355en_HK
dc.identifier.scopusauthoridRustom, R=7003492863en_HK
dc.identifier.scopusauthoridAyub, W=6507629388en_HK
dc.identifier.scopusauthoridMikhail, A=7006382484en_HK
dc.identifier.scopusauthoridThomas, M=7404754688en_HK
dc.identifier.citeulike2932396-

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