肾脏疾病
浪费的
医学
炎症
疾病
重症监护医学
病因学
蛋白质分解代谢
全身炎症
血液透析
生物信息学
内科学
生物
生物化学
氨基酸
出处
期刊:Current Opinion in Nephrology and Hypertension
[Ovid Technologies (Wolters Kluwer)]
日期:2008-03-01
卷期号:17 (2): 162-167
被引量:68
标识
DOI:10.1097/mnh.0b013e3282f5dbce
摘要
Purpose of review Protein-energy wasting and chronic inflammation are important comorbid conditions that predict poor clinical outcome in patients with advanced chronic kidney disease. The current article aims to provide a brief overview of the etiology and nutritional consequences of chronic inflammation with an outline of potential treatment options. Recent findings The exact mechanisms leading to these unfavorable conditions are not fully elucidated and are most likely multifactorial. Irrespective of the specific etiologic mechanisms, it appears that the common pathway for all the metabolic derangements is related to exaggerated protein degradation relative to protein synthesis. Several studies suggest that chronic inflammation can predispose advanced chronic kidney disease patients to a catabolic state leading to worsening of protein-energy wasting by both increasing protein breakdown and decreasing protein synthesis. Chronic administration of nutritional supplementation, both parenterally and orally, improves nutritional status even in inflamed hemodialysis patients. Several pilot studies indicate that antiinflammatory intervention can also improve the metabolic and nutritional profiles. Summary While a single common etiology has not been identified in this complex process, nutritional and antiinflammatory interventions can provide potential treatment options to improve the high mortality and morbidity in patients with advanced chronic kidney disease.
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