Anabolic Steroid(AS) on Nutritional Parameters in Malnourished Continuous Ambulatory Peritoneal Dialysis(CAPD) Patients

Kim, Moon Jae; Kwon, Kun Ho; Lee, Seoung Woo

Abstract

Protein-energy malnutrition is frequently observed in CAPD patients and is closely correlated with morbidity and mortality. We investigated the effects of AS on nutritional parameters in malnourished CAPD patients. Eleven CAPD patients who were proved to be malnourished by biochemical and anthropometric measurements, not admitted for 2 months recently, received intramuscularly 200mg of Nandrolone Decanoate, monthly. After AS was administered for more than 12 weeks, the nutritional parameters were checked. The mean age of patients was 53.5+/-9.8(SD) years, the sex ratio was 4:7. The mean duration of CAPD was 34.5+/-23.2 months. Three patients were diabetics. The mean duration of AS administered was 22.0+/-3.6 weeks. Eight of eleven patients improved their subjective symptoms such as appetite and muscle strength. There were significant increases in hemoglobin(7.0+/-0.9 vs. 7.8+/-1.1g/dl), hematocrit(20.3+/-2.8 vs. 23.0+/-2.8%), insulin-like growth factor I(165.9+/-71.6 vs. 207.1+/-69.5ng/ml), prealbumin(30.1+/-11.0 vs. 39.3+/-9.1mg/dl), transferrin(205.4+/-48.8 vs. 239.6+/-47.7mg/dl) and nPCR(0.75+/-0.15 vs. 0.84+/-0.15g/kg/day)(P<0.05). There were no changes in albumin, total lymphocyte, cholesterol, weeklky Kt/Vurea, weekly creatinine clearance and urea nitrogen appearance. On anthropometric measurements, midarm muscle circumference(21.8+/-3.2 vs. 22.7+/-3.5cm, P<0.05) and % lean body mass(57.6+/-12.7 vs. 60.5+/-11.4%, P<0.05) were increased, but triceps skinfold thickness, and body mass index were not changed. Edema was observed in 8 patients and acne was noted in a patient. Severe edema and ultrafiltration failure were observed in 2 patients. The mean time that edema developed was 17.6 4.6 weeks. In conclusion, AS seems to be useful in correcting malnutrition with their protein anabolic effect in malnourished CAPD patients.