Korean Journal of Nephrology 2009;28(4):302-309.
Low Dose Megestrol Acetate for Maintenance Hemodialysis Patients
Jung-Hwan Park, M.D.1, Eun Lee, M.S.2, Young-Il Jo, M.D.1, Jong-Oh Song, M.D.1 and Jong-Ho Lee, M.D.1
Department of Nephrology1
Konkuk University, School of Medicine Department of Nutrition2 Konkuk University Hospital
임상연구 : 혈액투석 환자에서 저용량 Megestrol Acetate 복용이 영양학적 지표에 미치는 영향
박정환1, 이 은2, 조영일1, 송종오1, 이종호1
건국대학교 의학전문대학원 신장내과1, 건국대학교병원 영양과2
Abstract
Purpose: Maintenance hemodialysis (HD) patients have a high prevalence of malnutrition and inflammation. Megestrol acetate (MA) has been shown to increase appetite in cancer patients but the usual dose of MA (400-800 mg/day) was associated with serious side effects in HD patients. We evaluated the changes in nutritional and inflammatory parameters after low dose of MA treatment in malnourished HD patients Methods:Inclusion criteria were maintenance HD patients who showed serum albumin <3.5 g/dL or <4.0 g/dL with anorexia. Serum chemical parameters, cytokines, Subjective Global Assessment, dry weight, Kt/V, nPCR, SF36 quality of life, fat free mass (FFM), and body fat mass (BFM) were measured. Patients were instructed to take 5 mL (200 mg) of MA solution once a day. Results:Fourteen patients (seven male, age 52±10 years, mean HD duration 48±59 months) were included. One patient died of pneumonia. Seven patients dropped out because they refused to take the drug after one to three months of treatment; two of them complained of thirst, three of them ate too much, and two had both. Six patients (four male and two female) have completed six months of study. Serum albumin (3.1±0.5 to 3.6±0.4 g/dL), TIBC (184.2±27.9 to 205.0±25.8 μg/ dL), BFM (11.9±5.7 to 16.6±7.4 kg), protein intake (57.0±32.5 to 68.7±39.2 g/day), and energy intake (1,521± 690 to 1,724±879) were increased. Serum CRP and IL-6 decreased without statistical significance. No significant adverse effects were observed in all patients who had completed study. Conclusion:Low dose MA can improve the nutritional status, inflammation, and anorexia in maintenance HD patients.
Key Words: Megestrol acetate, Malnutrition, Hemodialysis


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