Advances in anabolic interventions for malnourished dialysis patients.
Malnutrition is a frequent state during maintenance dialysis. Among a variety of reasons, chronic catabolic events as well as resistance to anabolic compounds do induce an imbalance in protein metabolism and favor a chronic loss in protein mass. Anabolic effects have been obtained in pilot studies with recombinant growth hormone and insulin-like growth factor-1 in adult dialysis patients. More recently, the come back of androgen therapy provided reports of a positive impact on body composition and physical activity during maintenance dialysis. Strong improvement in nutritional status has also been obtained by more frequent dialysis sessions, either during long nocturnal or short daily schedules. Thus, promising new therapies are emerging to fight the important incidence of malnutrition in dialysis patients.