Recombinant human growth hormone improves muscle amino acid uptake and whole-body protein metabolism in chronic hemodialysis patients.

Pupim LB, Flakoll PJ, Yu C, Ikizler TA
Am J Clin Nutr. 2005 82 (6): 1235-43

PMID: 16332656 · DOI:10.1093/ajcn/82.6.1235

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.

MeSH Terms (19)

Adult Amino Acids Carbon Isotopes Cross-Over Studies Energy Metabolism Exercise Female Human Growth Hormone Humans Kidney Failure, Chronic Male Muscle, Skeletal Oxidation-Reduction Oxygen Consumption Parenteral Nutrition Proteins Recombinant Proteins Renal Dialysis Treatment Outcome

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