Muscle Weakness Clinical Trial
Official title:
Anabolic Steroids and Exercise in Hemodialysis Patients
This is a study to find out whether an exercise program during dialysis or a drug called nandrolone decanoate can increase muscle size and strenght in patients on dialysis.
Dialysis patients have limited physical functioning as measured by self-reported
functioning, peak oxygen consumption, physical performance tests, and tests of muscle
strength. A recent study highlighted the severity of debility, reporting that more than one
third of hemodialysis patients were unable to perform the normal activities of daily living
without assistance. In addition, physical functioning has been shown to be a major
determinant of patients' assessment of their global quality of life. Taken together,
available evidence suggests that impaired physical functioning is widespread among dialysis
patients and profoundly affects their lives. Therefore, interventions to improve functioning
in this population have the potential to significantly improve quality of life.
Muscle wasting and weakness are particularly attractive targets for intervention because
they are related to loss of function and can be objectively measured and targeted for
improvement. Small studies support the possible benefits of two strategies to increase
muscle size and strength among patients on dialysis. Anabolic steroids were frequently used
to ameliorate the anemia associated with end-stage renal disease prior to the introduction
of recombinant erythropoietin, and these agents were noted to cause an increase in serum
creatinine along with increases in hemoglobin and hematocrit. More recently, nandrolone
decanoate has been shown to increase lean body mass and improve physical performance, and
resistance exercise training has been shown to increase strength and improve physical
performance. Neither of these preliminary results has been confirmed, nor have the relative
benefits of these strategies or their potential additive or synergistic effects been
examined. Therefore, we designed a study to compare changes in lean body mass, muscle size
and strength, physical performance, and self-reported functioning over a12 week period among
hemodialysis patients randomly assigned to one of four groups: 1) nandrolone decanoate, a
synthetic testosterone derivative, by weekly intramuscular injection (ND); 2) weekly placebo
injections (PL); 3) lower extremity resistance exercise training during dialysis sessions
three times per week plus weekly placebo injections (EX); and 4) resistance exercise plus
nandrolone injections weekly (EX+ND).
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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