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Chronic kidney disease as a metabolic syndrome with malnutrition--need for strict control of risk factors.

Abstract

Patients with chronic kidney disease (CKD) have an increased risk for death from cardiovascular disease (CVD). They have multiple metabolic abnormalities that may accelerate atherosclerosis, such as hypertension, insulin resistance, and dyslipidemia, along with other CKD-related risk factors. In addition, a considerable proportion of patients with advanced stages of CKD are malnourished, presenting "metabolic syndrome with malnutrition". The presence of malnutrition/inflammation dramatically changes the apparent relationship between CVD death risk and some risk factors. For example, in stage 5 CKD patients on hemodialysis, a higher body mass index and a higher plasma cholesterol are predictors of better survival. To understand the paradoxic epidemiology, we should recognize risk factors for occurrence of CVD events and risk factors of fatality after an event. In this article, we review the unique situation of CKD, emphasizing the need of more strict control of both types of risk factors to improve survival of CKD patients.

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    Source

    Internal medicine (Tokyo, Japan) 44:3 2005 Mar pg 179-87

    MeSH

    Chronic Disease
    Humans
    Kidney Failure, Chronic
    Malnutrition
    Metabolic Syndrome X
    Risk Factors
    Survival Rate
    World Health

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    15805704

    Citation

    TY - JOUR T1 - Chronic kidney disease as a metabolic syndrome with malnutrition--need for strict control of risk factors. AU - Shoji,Tetsuo, AU - Nishizawa,Yoshiki, PY - 2005/4/5/pubmed PY - 2005/7/1/medline PY - 2005/4/5/entrez SP - 179 EP - 87 JF - Internal medicine (Tokyo, Japan) JO - Intern. Med. VL - 44 IS - 3 N2 - Patients with chronic kidney disease (CKD) have an increased risk for death from cardiovascular disease (CVD). They have multiple metabolic abnormalities that may accelerate atherosclerosis, such as hypertension, insulin resistance, and dyslipidemia, along with other CKD-related risk factors. In addition, a considerable proportion of patients with advanced stages of CKD are malnourished, presenting "metabolic syndrome with malnutrition". The presence of malnutrition/inflammation dramatically changes the apparent relationship between CVD death risk and some risk factors. For example, in stage 5 CKD patients on hemodialysis, a higher body mass index and a higher plasma cholesterol are predictors of better survival. To understand the paradoxic epidemiology, we should recognize risk factors for occurrence of CVD events and risk factors of fatality after an event. In this article, we review the unique situation of CKD, emphasizing the need of more strict control of both types of risk factors to improve survival of CKD patients. SN - 0918-2918 UR - https://www.unboundmedicine.com/medline/citation/15805704/full_citation L2 - http://joi.jlc.jst.go.jp/JST.JSTAGE/internalmedicine/44.179?from=PubMed ER -