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Pediatric Nephrology

, Volume 25, Issue 4, pp 711–724 | Cite as

Inflammation and cachexia in chronic kidney disease

  • Wai W. Cheung
  • Kyung Hoon Paik
  • Robert H. MakEmail author
Review

Abstract

Chronic inflammation is associated with cachexia and increased mortality risk in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). Inflammation suppresses appetite and causes the loss of protein stores. In CKD patients, increased serum levels of pro-inflammatory cytokines may be caused by reduced renal function, volume overload, oxidative or carbonyl stress, decreased levels of antioxidants, increased susceptibility to infection in uremia, and the presence of comorbid conditions. Cachexia is brought about by the synergistic combination of a dramatic decrease in appetite and an increase in the catabolism of fat and lean body mass. Pro-inflammatory cytokines act on the central nervous system to alter appetite and energy metabolism and to provide a signal—through the nuclear factor-κB and ATP-ubiquitin-dependent proteolytic pathways—that causes muscle wasting. Further research into the molecular pathways leading to inflammation and cachexia may lead to novel therapeutic therapies for this devastating and potentially fatal complication of chronic disease.

Keywords

Cachexia Chronic kidney disease Cytokines End-stage renal failure Inflammation Melanocortin signaling Muscle wasting Neuropeptides 

Notes

Acknowledgments

This work was supported by the Amgen Young Investigator Grant of the National Kidney Foundation to WC and grants from the National Institute of Health (K24 DK59574), Baxter Renal Discovery Program, and the Satellite Foundation to RM. KHP was supported by a grant from Korean Society of Pediatric Nephrology.

Conflict of interest statement

The authors declare that no conflict of interest exists.

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Copyright information

© IPNA 2010

Authors and Affiliations

  • Wai W. Cheung
    • 1
  • Kyung Hoon Paik
    • 2
  • Robert H. Mak
    • 1
    Email author
  1. 1.Division of Pediatrics Nephrology, Department of PediatricsUniversity of California San DiegoLa JollaUSA
  2. 2.Department of Pediatrics, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea

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