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Protein-Energy Malnutrition

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Nutrition in Kidney Disease

Part of the book series: Nutrition and Health ((NH))

Summary

Protein-energy malnutrition is common in stage 5 chronic kidney disease (CKD) and usually associated with anorexia, chronic inflammation, kidney disease wasting (KDW), refractory anemia and poor outcome including high risk of cardiovascular disease and death. Uremia, endocrine and gastrointestinal disorders, and oxidative and carbonyl stress may engender this type of malnutrition. The dialysis treatment and techniques may also contribute to the protein-energy malnutrition. The term Malnutrition-Inflammation-Cachexia Syndrome (MICS) underscores the close link between the protein-energy malnutrition and inflammation and their concomitant contribution to the KDW. The MICS is associated with poor short-term survival and may result in paradoxical associations between some cardiovascular risks, and such relationships are continuing to be studied in the emerging theory known as the obesity paradox or “reverse epidemiology." Four major nutritional evaluation categories in dialysis patients include the assessment of nutritional intake, body composition and laboratory markers and the nutritional scoring systems. Dietary supplements and nutritional and pharmacological interventions that can stimulate appetite, mitigate inflammation and enhance protein and energy intake may improve survival in patients with stage 5, CKD although scientific evidence for or against such effects are currently inadequate.

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Author information

Authors and Affiliations

  1. Department of Medicine and Pediatrics, David Geffen UCLA School of Medicine, Torrance, California

    Kamyar Kalantar-Zadeh MD, MPH, PHD

Authors
  1. Kamyar Kalantar-Zadeh MD, MPH, PHD
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Editors and Affiliations

  1. Department of Nutritional Sciences, University of Medicine and Dentistry of New Jersey, 40 East Laurel Rd, Stratford, NJ, USA

    Laura D. Byham-Gray

  2. Division of Nephrology, Stanford University School of Medicine, 3333 California St, Stanford, CA, USA

    Glenn M. Chertow

  3. Department of Nutrition, C.W. Post Campus Long Island University, 720 Northern Blvd, Brookville, NY, USA

    Jerrilynn D. Burrowes

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© 2008 Humana Press, Totowa, NJ

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Kalantar-Zadeh, K. (2008). Protein-Energy Malnutrition. In: Byham-Gray, L.D., Chertow, G.M., Burrowes, J.D. (eds) Nutrition in Kidney Disease. Nutrition and Health. Humana Press. https://doi.org/10.1007/978-1-59745-032-4_11

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  • DOI: https://doi.org/10.1007/978-1-59745-032-4_11

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-781-5

  • Online ISBN: 978-1-59745-032-4

  • eBook Packages: MedicineMedicine (R0)

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