AJCN Cancer Health Disparities Conference
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Pupim, L. B
Right arrow Articles by Ikizler, T A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pupim, L. B
Right arrow Articles by Ikizler, T A.
Agricola
Right arrow Articles by Pupim, L. B
Right arrow Articles by Ikizler, T A.
American Journal of Clinical Nutrition, Vol. 82, No. 6, 1235-1243, December 2005
© 2005 American Society for Clinical Nutrition

ORIGINAL RESEARCH COMMUNICATION

Recombinant human growth hormone improves muscle amino acid uptake and whole-body protein metabolism in chronic hemodialysis patients1,2,3

Lara B Pupim, Paul J Flakoll, Chang Yu and T Alp Ikizler

1 From the Department of Medicine, Division of Nephrology (LBP and TAI), and the Department of Biostatistics (CY), Vanderbilt University Medical Center, Nashville, TN, and the Center for Designing Foods to Improve Nutrition, Food Science and Human Nutrition, Iowa State University, Ames, IA (PJF)

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-[1-13C]leucine.

Results: Whole-body net protein balance was –0.50 ± 0.07 mg · kg fat-free mass–1 · min–1 when the patients did not receive rhGH and –0.39 ± 0.04 mg · kg fat-free mass–1 · 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.

Key Words: Hemodialysis • metabolism • intradialytic parenteral nutrition • exercise • growth hormone






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2005 by The American Society for Nutrition