Protein Energy Wasting in Chronic Kidney Disease

  • Eiichiro Kanda


Chronic kidney disease (CKD) patients are increasing in number globally because kidney function is affected by aging and lifestyle habits. Malnutrition, muscle weakness, and a decline in activities of daily living (ADL) are often observed in elderly CKD patients and dialysis patients, and are related to their CKD prognosis and life prognosis. Chronic inflammation and atherosclerotic disease are associated with malnutrition. Because malnutrition and its related factors affect their prognosis, it is necessary to find and treat patients with malnutrition at an early stage. The state in which the storage of protein and energy source accompanying CKD is decreased is called protein energy wasting (PEW). PEW is diagnosed on the basis of biochemical tests finding such as hypoalbuminemia, physique, muscle mass, and loss of dietary intake. For evaluating PEW, a complex nutritional index taking into account the pathophysiology specific to CKD patients is useful. Because PEW involves various factors such as nutritional status, muscular strength, ADL, and social life, the combined effect of various problems exacerbates PEW and affects life prognosis of CKD patients and dialysis patients. Taking these factors into consideration, not only nutritional therapy but also exercise therapy is necessary to stop the vicious cycle related to the decline of PEW and ADL.


Chronic kidney disease Dialysis Protein energy wasting Inflammation Malnutrition Albumin 


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© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Eiichiro Kanda
    • 1
  1. 1.Medical ScienceKawasaki Medical SchoolKurashikiJapan

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