PYRAZINOYLGUANIDINE IN END-STAGE RENAL-DISEASE - A PROSPECTIVE, PLACEBO-CONTROLLED PILOT-STUDY

Cardiovascular disease is the leading cause of mortality in end-stage renal disease (ESRD) patients receiving dialysis. In these patients, h ypertriglyceridemia appears to increase the risk of accelerated athero sclerosis. The present placebo-controlled study evaluated prospectivel y lipid-lowering effects of pyrazinoylguanidine (PZG) in 6 ESRD patien ts undergoing maintenance hemodialysis. The design of the study entail ed a placebo phase of 1 week followed by 3 weeks of PZG, 400 mg three times a day. Compared to placebo, PZG reduced serum triglycerides (PZG vs. placebo 370 +/- 171 vs. 414 +/- 152 mg/dl; p = 0.01), PZG also te nded to decrease total cholesterol. In addition, PZG selectively lower ed blood glucose in hyperglycemic patients. PZG was well tolerated: it did not interfere with hemodynamic parameters or alter liver function tests, nutritional parameters or dialysis clearance.