PMID- 26776251
OWN - NLM
STAT- MEDLINE
DCOM- 20180123
LR  - 20181202
IS  - 1532-8503 (Electronic)
IS  - 1051-2276 (Linking)
VI  - 26
IP  - 3
DP  - 2016 May
TI  - The Efficacy and Safety of Megestrol Acetate in Protein-Energy Wasting due to 
      Chronic Kidney Disease: A Systematic Review.
PG  - 168-76
LID - S1051-2276(15)00197-1 [pii]
LID - 10.1053/j.jrn.2015.11.002 [doi]
AB  - OBJECTIVE: To assess the efficacy and safety of oral megestrol acetate (MA) in 
      the management of protein-energy wasting in patients with chronic kidney disease 
      (CKD). DESIGN: A systematic review of English published literature from 1970 
      until April 1, 2014. SUBJECTS: All adult patients with CKD including both 
      dialysis and non-dialysis-dependent. INTERVENTION: Oral MA. MAIN OUTCOME MEASURE: 
      Efficacy outcomes included changes in body weight, serum albumin, and appetite. 
      Safety outcomes examined included adverse events (AEs) and deaths. RESULTS: A 
      total of 9 studies met the inclusion criteria. No data on MA in non-dialysis CKD 
      patients were available. Statistically significant increases in body weight 
      (range 1.5-5 kg) were reported in 6 trials. Statistically significant increases 
      in albumin (range of 0.22 g/dL-0.52 g/dL) were observed in 5 trials. Improved 
      appetite was observed in 7 trials. All trials were limited by small sample sizes 
      (range 9-32 subjects), short duration (range 8-24 weeks), a high degree of bias, 
      and absence of clinical outcomes such as quality of life or hospitalizations. 
      Forty-seven AEs were reported and included overhydration/excessive fluid gain, 
      diarrhea, hyperglycemia, excessive weight gain, suppressed cortisol levels, 
      thrombophlebitis, nausea/vomiting, confusion/hallucinations, vaginal bleeding, 
      headache/dizziness, and elevated lactate dehydrogenase. There were 26 
      discontinuations due to death. CONCLUSION: The current evidence for treatment 
      with MA in patients receiving dialysis is sparse with few high-quality trials. 
      The safety of using MA beyond 24 weeks is unknown, and use of MA is associated 
      with significant AEs. At this time, oral MA should be used with significant 
      caution, and only when other treatment options are unavailable.
CI  - Copyright (c) 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All 
      rights reserved.
FAU - Wazny, Lori D
AU  - Wazny LD
AD  - College of Pharmacy, University of Manitoba, Winnipeg, MB, Canada; Pharmacy 
      Program, Winnipeg Regional Health Authority, Winnipeg, MB, Canada; Manitoba Renal 
      Program, Manitoba, Canada. Electronic address: Lwazny@hsc.mb.ca.
FAU - Nadurak, Stewart
AU  - Nadurak S
AD  - Manitoba Renal Program, Manitoba, Canada.
FAU - Orsulak, Cali
AU  - Orsulak C
AD  - Pharmacy Program, Winnipeg Regional Health Authority, Winnipeg, MB, Canada; 
      Manitoba Renal Program, Manitoba, Canada.
FAU - Giles-Smith, Lori
AU  - Giles-Smith L
AD  - University of Manitoba, Health Sciences Libraries, Winnipeg, MB, Canada.
FAU - Tangri, Navdeep
AU  - Tangri N
AD  - Departments of Medicine and Community Health Sciences, University of Manitoba, 
      Winnipeg, MB, Canada; Manitoba Renal Program, Manitoba, Canada.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20160106
PL  - United States
TA  - J Ren Nutr
JT  - Journal of renal nutrition : the official journal of the Council on Renal 
      Nutrition of the National Kidney Foundation
JID - 9112938
RN  - 0 (Appetite Stimulants)
RN  - 0 (Serum Albumin)
RN  - TJ2M0FR8ES (Megestrol Acetate)
SB  - IM
MH  - Appetite
MH  - *Appetite Stimulants
MH  - Body Weight
MH  - Humans
MH  - Megestrol Acetate/*adverse effects/*therapeutic use
MH  - Nutritional Status
MH  - Quality of Life
MH  - Renal Dialysis
MH  - Renal Insufficiency, Chronic/*complications/physiopathology
MH  - Serum Albumin/analysis
MH  - Treatment Outcome
MH  - Wasting Syndrome/*drug therapy/etiology
MH  - Weight Gain
EDAT- 2016/01/19 06:00
MHDA- 2018/01/24 06:00
CRDT- 2016/01/19 06:00
PHST- 2015/07/03 00:00 [received]
PHST- 2015/10/01 00:00 [revised]
PHST- 2015/11/03 00:00 [accepted]
PHST- 2016/01/19 06:00 [entrez]
PHST- 2016/01/19 06:00 [pubmed]
PHST- 2018/01/24 06:00 [medline]
AID - S1051-2276(15)00197-1 [pii]
AID - 10.1053/j.jrn.2015.11.002 [doi]
PST - ppublish
SO  - J Ren Nutr. 2016 May;26(3):168-76. doi: 10.1053/j.jrn.2015.11.002. Epub 2016 Jan 
      6.