Singhi U, Perius M, Williams J, Sigled D, Urbanes A, Shapiro
H
Toxicity of megestrol in malnourished chronic dialysis patients
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1464 1996
In oncology patients, megestrol has been found to increase appetite and
result in weight gain with
few to any significant side effects. A randomized double blinded, placebo-
controlled crossover
study was conducted in 19 chronic hemodialysis patients to evaluate the role
of low-dose megestrol
in the treatment of malnutrition (defined as a serum albumin level of <
3.9 g/dl). Patients were
given 80 mg/day of megestrol for three months, followed by placebo for three
months. Six patients
withdrew due to side-effects, principally diarrhea. Megestrol is excreted by
the kidney and is not
removed by hemodialysis.
Two patients died from causes unrelated to the study. In the 11 patients
completing the study,
megestrol did not produce any statistically significant improvement in serum
albumin levels or in
fat-free body mass.
Comment: In ESRD patients, megestrol did not improve nutritional
status and was associated
with a high incidence of side-effects.
(Michael V. Rocco, M.D., Bowman Gray School of Medicine)
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