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Etiology of the protein-energy wasting syndrome in chronic kidney disease: a consensus statement from the International Society of Renal Nutrition and Metabolism (ISRNM).

Abstract

Protein-energy wasting (PEW), a term proposed by the International Society of Renal Nutrition and Metabolism (ISRNM), refers to the multiple nutritional and catabolic alterations that occur in chronic kidney disease (CKD) and associate with morbidity and mortality. To increase awareness, identify research needs, and provide the basis for future work to understand therapies and consequences of PEW, ISRNM provides this consensus statement of current knowledge on the etiology of PEW syndrome in CKD. Although insufficient food intake (true undernutrition) due to poor appetite and dietary restrictions contribute, other highly prevalent factors are required for the full syndrome to develop. These include uremia-induced alterations such as increased energy expenditure, persistent inflammation, acidosis, and multiple endocrine disorders that render a state of hypermetabolism leading to excess catabolism of muscle and fat. In addition, comorbid conditions associated with CKD, poor physical activity, frailty, and the dialysis procedure per se further contribute to PEW.

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    MeSH

    Adipokines
    Comorbidity
    Consensus
    Energy Metabolism
    Humans
    Inflammation
    Life Style
    Motor Activity
    Nutritional Status
    Obesity, Abdominal
    Prevalence
    Protein-Energy Malnutrition
    Renal Dialysis
    Renal Insufficiency, Chronic
    Wasting Syndrome

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    23428357

    Citation

    TY - JOUR T1 - Etiology of the protein-energy wasting syndrome in chronic kidney disease: a consensus statement from the International Society of Renal Nutrition and Metabolism (ISRNM). AU - Carrero,Juan Jesús, AU - Stenvinkel,Peter, AU - Cuppari,Lilian, AU - Ikizler,T Alp, AU - Kalantar-Zadeh,Kamyar, AU - Kaysen,George, AU - Mitch,William E, AU - Price,S Russ, AU - Wanner,Christoph, AU - Wang,Angela Y M, AU - ter Wee,Pieter, AU - Franch,Harold A, PY - 2013/1/15/received PY - 2013/1/15/accepted PY - 2013/2/23/entrez PY - 2013/2/23/pubmed PY - 2013/9/13/medline SP - 77 EP - 90 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 23 IS - 2 N2 - Protein-energy wasting (PEW), a term proposed by the International Society of Renal Nutrition and Metabolism (ISRNM), refers to the multiple nutritional and catabolic alterations that occur in chronic kidney disease (CKD) and associate with morbidity and mortality. To increase awareness, identify research needs, and provide the basis for future work to understand therapies and consequences of PEW, ISRNM provides this consensus statement of current knowledge on the etiology of PEW syndrome in CKD. Although insufficient food intake (true undernutrition) due to poor appetite and dietary restrictions contribute, other highly prevalent factors are required for the full syndrome to develop. These include uremia-induced alterations such as increased energy expenditure, persistent inflammation, acidosis, and multiple endocrine disorders that render a state of hypermetabolism leading to excess catabolism of muscle and fat. In addition, comorbid conditions associated with CKD, poor physical activity, frailty, and the dialysis procedure per se further contribute to PEW. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/23428357/full_citation L2 - http://linkinghub.elsevier.com/retrieve/pii/S1051-2276(13)00006-X ER -