Johansen KL et al. (2006) Effects of resistance exercise training and nandrolone decanoate on body composition and muscle function among patients who receive hemodialysis: a randomized, controlled trial. J Am Soc Nephrol 17: 2307–2314

Muscle wasting and weakness are common in hemodialysis patients, interfering with their ability to perform everyday activities and thereby reducing quality of life. A new study shows that nandrolone decanoate—a synthetic testosterone derivative—and resistance training increase muscle size and strength, and improve physical function, in maintenance hemodialysis patients.

Seventy-nine patients were randomized to receive either nandrolone (100 mg or 200 mg once a week for women and men, respectively) or placebo injections, with or without lower extremity resistance exercise training during thrice-weekly dialysis sessions, for 12 weeks. Analysis of data from the 68 patients who completed the study showed that nandrolone, but not exercise alone, significantly increased lean body mass (average increase 3.1 ± 2.2 kg; P <0.001). Lower extremity exercise and nandrolone both markedly increased quadricep cross-sectional area (P = 0.02 and P <0.001, respectively) in an additive manner. Muscles that were exercised became stronger (P <0.0001 for knee extension, hip abduction and hip flexion). Compared with their non-exercising counterparts, patients in the exercise groups reported improved physical functioning and less fatigue.

One participant withdrew from the nandrolone group because of interference with sexual function. The steroid also increased anger, an effect that was offset by exercise. The authors conclude that nandrolone and resistance training are safe and effective approaches to improving muscle weakness in stable hemodialysis patients.