演題情報

学会・委員会企画

開催回
第56回・2011年・横浜
 

Anabolic interventions in Dialysis Patients

演題番号 : GI-7-5

T. Alp Ikizler:1

1:Vanderbilt University Medical Center, Nashville, TN, USA

 

End-stage renal disease (ESRD) patients on maintenance dialysis commonly develop a unique type of metabolic and nutritional abnormality termed as protein-energy wasting (PEW). PEW is closely associated with poor survival in this patient population. There have been several advances in anabolic interventions aimed at improving PEW in these patients in recent years. Oral or parenteral nutritional supplementation, especially if administered during dialysis, improves net protein anabolism in chronic hemodialysis (CHD) patients. These beneficial effects have been extended to long-term benefits in recent clinical trials. Resistance exercise, alone or combined with intradialytic oral nutrition supplementation also improves net protein balance in the acute setting although recent studies indicated a limited beneficial effect of long-term exercise alone on muscle protein accretion in chronic hemodialysis patients. Anabolic agents such as growth hormone and androgens have been shown to exert significant benefits on muscle mass and strength. Ghrelin, a hormone with combined orexigenic and anti-inflammatory effects, is a potential new nutritional intervention in maintenance dialysis patients. Several pilot studies indicate a potential benefit of improving inflammatory state on nutritional biomarkers. In summary, existing anabolic therapeutic strategies are effective in improving PEW in maintenance dialysis patients. Combined anabolic interventions and several new and established anabolic strategies represent as further promising nutritional interventions. In this presentation, we will discuss these studies aimed at improving PEW in ESRD patients and examine their effects on clinically meaningful outcomes.

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