A super-agonist of growth hormone-releasing hormone causes rapid improvement of nutritional status in patients with chronic kidney disease

Stanisaw Niemczyk, Hanna Sikorska, Andrzej Wiȩcek, Ewa Zukowska-Szczechowska, Klaudia Zalȩcka, Joanna Gorczyńska, Magorzata Kubik, Beata Czerwieńska, Katarzyna Gosek, Johannes D. Veldhuis, David A. Wagner, Pierrette Gaudreau, Tiina Hakonen, Sam Wai Kit Kay, Taneli Jouhikainen, Franz Schaefer

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Chronic kidney disease is frequently associated with protein-energy wasting related to chronic inflammation and a resistance to anabolic hormones such as insulin and growth hormone (GH). In this study, we determined whether a new GH-releasing hormone super-agonist (AKL-0707) improved the anabolism and nutritional status of nondialyzed patients with stage 4-5 chronic kidney disease randomized to twice daily injections of the super-agonist or placebo. After 28 days, this treatment significantly increased 24-h GH secretion by almost 400%, without altering the frequency or rhythmicity of secretory bursts or fractional pulsatile GH release, and doubled the serum insulin-like growth factor-1 level. There was a significant change in the Subjective Global Assessment from mildly to moderately malnourished to well-nourished in 6 of 9 patients receiving AKL-0707 but in none of 10 placebo-treated patients. By dual-energy X-ray absorptiometry, both the mean fat-free mass and the body mineral content increased, but fat mass decreased, all significantly. In the AKL-0707-treated group, both serum urea and normalized protein equivalent of nitrogen appearance significantly decreased with no change in dietary protein intake, indicating a protein anabolic effect of treatment. Thus, our study shows that stimulation of endogenous GH secretion by AKL-0707 overcomes uremic catabolism of patients with advanced chronic kidney disease.

Original languageEnglish (US)
Pages (from-to)450-458
Number of pages9
JournalKidney international
Volume77
Issue number5
DOIs
StatePublished - Mar 2010

Keywords

  • Body composition
  • Chronic kidney disease
  • Growth hormone
  • Malnutrition

ASJC Scopus subject areas

  • Nephrology

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    Niemczyk, S., Sikorska, H., Wiȩcek, A., Zukowska-Szczechowska, E., Zalȩcka, K., Gorczyńska, J., Kubik, M., Czerwieńska, B., Gosek, K., Veldhuis, J. D., Wagner, D. A., Gaudreau, P., Hakonen, T., Kay, S. W. K., Jouhikainen, T., & Schaefer, F. (2010). A super-agonist of growth hormone-releasing hormone causes rapid improvement of nutritional status in patients with chronic kidney disease. Kidney international, 77(5), 450-458. https://doi.org/10.1038/ki.2009.480