Document Detail


Recombinant human growth hormone improves muscle amino acid uptake and whole-body protein metabolism in chronic hemodialysis patients.
MedLine Citation:
PMID:  16332656     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intradialytic parenteral nutrition (IDPN), with or without exercise, has been shown to reverse the net negative whole-body and forearm muscle protein balances observed during hemodialysis. Pharmacologic doses of recombinant human growth hormone (rhGH) constitute another potential anabolic therapy in chronic hemodialysis patients. OBJECTIVE: Our goal was to examine the potential additive anabolic effects of rhGH compared with IDPN and exercise on protein and energy homeostasis. DESIGN: We studied 7 chronic hemodialysis patients in a crossover design study in which each subject participated in 2 protocols: GH (rhGH + IDPN + exercise) and no GH (IDPN + exercise). During the GH protocol, the subjects were studied after 3 daily doses of rhGH. Each subject was studied 2 h before, 4 h during, and 2 h after a hemodialysis session with the use of a primed, constant infusion of l-[1-(13)C]leucine. RESULTS: Whole-body net protein balance was -0.50 +/- 0.07 mg x kg fat-free mass(-1) x min(-1) when the patients did not receive rhGH and -0.39 +/- 0.04 mg x kg fat-free mass(-1) x min(-1) when the patients received rhGH, a 22% improvement in prehemodialysis whole-body protein homeostasis (P < 0.05). Essential amino acid muscle loss was also significantly less during the prehemodialysis period when rhGH was administered (-18 +/- 23 compared with -71 +/- 20 mmol/L; P < 0.05). The whole-body anabolic effects of rhGH observed during the prehemodialysis period persisted throughout the entire study, as evidenced by a lack of significant interaction or main effect of treatment during hemodialysis and in the posthemodialysis period. CONCLUSION: rhGH improves whole-body protein homeostasis in chronic hemodialysis patients.
Authors:
Lara B Pupim; Paul J Flakoll; Chang Yu; T Alp Ikizler
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of clinical nutrition     Volume:  82     ISSN:  0002-9165     ISO Abbreviation:  Am. J. Clin. Nutr.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-12-07     Completed Date:  2006-01-05     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0376027     Medline TA:  Am J Clin Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1235-43     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN 37232-2372, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amino Acids / blood,  metabolism*
Carbon Isotopes
Cross-Over Studies
Energy Metabolism / drug effects,  physiology
Exercise / physiology
Female
Human Growth Hormone / pharmacology*
Humans
Kidney Failure, Chronic / metabolism,  therapy
Male
Muscle, Skeletal / metabolism*
Oxidation-Reduction
Oxygen Consumption / drug effects,  physiology
Parenteral Nutrition
Proteins / metabolism*
Recombinant Proteins / pharmacology*
Renal Dialysis* / adverse effects
Treatment Outcome
Grant Support
ID/Acronym/Agency:
DK-20593/DK/NIDDK NIH HHS; DK-26657/DK/NIDDK NIH HHS; FDA000943/FD/FDA HHS; K24 DK62849/DK/NIDDK NIH HHS; M01 RR 00095/RR/NCRR NIH HHS; R01 DK45604/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Amino Acids; 0/Carbon Isotopes; 0/Proteins; 0/Recombinant Proteins; 12629-01-5/Human Growth Hormone

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