Effects of resistance training and Nadrolene Decanoate

Published ahead of print on July 6, 2006
Journal of the American Society of Nephrology
© 2006 American Society of Nephrology
Received January 13, 2006
Accepted on May 27, 2006

CLINICAL SCIENCE: Clinical Dialysis

Effects of Resistance Exercise Training and Nandrolone Decanoate on Body Composition and Muscle Function among Patients Who Receive Hemodialysis: A Randomized, Controlled Trial
Kirsten L. Johansen *1, Patricia L. Painter , Giorgos K. Sakkas , Patricia Gordon , Julie Doyle, and Tiffany Shubert

*Nephrology Section, San Francisco VA Medical Center and Departments of Medicine and Physiological Nursing, University of California, San Francisco, San Francisco, California; Department of Medicine, University of Thessaly, Thessaly, Greece; Northern California Institute for Research and Education, San Francisco, California; and University of North Carolina School of Medicine, Chapel Hill, Chapel Hill, North Carolina

1 To whom correspondence should be addressed. E-mail: kirsten.johansen@ucsf.edu.


Patients who are on hemodialysis commonly experience muscle wasting and weakness, which have a negative effect on physical functioning and quality of life. The objective of this study was to determine whether anabolic steroid administration and resistance exercise training induce anabolic effects among patients who receive maintenance hemodialysis. A randomized 2 x 2 factorial trial of anabolic steroid administration and resistance exercise training was conducted in 79 patients who were receiving maintenance hemodialysis at University of California, San Francisco-affiliated dialysis units. Interventions included double-blinded weekly nandrolone decanoate (100 mg for women; 200 mg for men) or placebo injections and lower extremity resistance exercise training for 12 wk during hemodialysis sessions three times per week using ankle weights. Primary outcomes included change in lean body mass (LBM) measured by dual-energy x-ray absorptiometry, quadriceps muscle cross-sectional area measured by magnetic resonance imaging, and knee extensor muscle strength. Secondary outcomes included changes in physical performance, self-reported physical functioning, and physical activity. Sixty-eight patients completed the study. Patients who received nandrolone decanoate increased their LBM by 3.1 ± 2.2 kg (P < 0.0001). Exercise did not result in a significant increase in LBM. Quadriceps muscle cross-sectional area increased in patients who were assigned to exercise (P = 0.01) and to nandrolone (P < 0.0001) in an additive manner. Patients who exercised increased their strength in a training-specific fashion, and exercise was associated with an improvement in self-reported physical functioning (P = 0.04 compared with nonexercising groups). Nandrolone decanoate and resistance exercise produced anabolic effects among patients who were on hemodialysis. Further studies are needed to determine whether these interventions improve survival.

Patricia Painter has done research on exercise since the 1980s and is a well respected exercise physiologist. Trish was an initial member of the Life Options Rehabilitation Advisory Council. Kirsten Johansen has written several articles on exercise and has collaborated with Trish before. Kirsten is a meber of the LORAC too. Medical Education Institute, Inc. that administers Home Dialysis Central also administers Life Options – http://www.lifeoptions.org where you can read several things about exercise.

So far as anabolic steroids are concerned, I noticed that the dose for women was half what it was for men. In the “old days” of dialysis, before EPO, almost every dialysis patient took nandrolone decanoate (Deca Durabolin is the brand name) to get their hemoglobin/hematocrit into the 20s. One side effect that women hated was unwanted facial hair growth and loss of hair on the head. Hopefully with the lowered dosage this didn’t happen in this research. Other research on exercise has established that higher physical functioning scores are linked with reduced hospitalizations so perhaps patients would be willing to bleach extra hair and wear a wig if adding this injectible drug would help them live longer and better.