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Protein Nutrition and Malnutrition in CKD and ESRD
Elevated protein catabolism and protein malnutrition are common in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). The underlying etiology includes, but is not limited to, metabolic acidosis intestinal dysbiosis; systemic inflammation with activation of complements, en...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372871/ https://www.ncbi.nlm.nih.gov/pubmed/28264439 http://dx.doi.org/10.3390/nu9030208 |
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author | Zha, Yan Qian, Qi |
author_facet | Zha, Yan Qian, Qi |
author_sort | Zha, Yan |
collection | PubMed |
description | Elevated protein catabolism and protein malnutrition are common in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). The underlying etiology includes, but is not limited to, metabolic acidosis intestinal dysbiosis; systemic inflammation with activation of complements, endothelin-1 and renin-angiotensin-aldosterone (RAAS) axis; anabolic hormone resistance; energy expenditure elevation; and uremic toxin accumulation. All of these derangements can further worsen kidney function, leading to poor patient outcomes. Many of these CKD-related derangements can be prevented and substantially reversed, representing an area of great potential to improve CKD and ESRD care. This review integrates known information and recent advances in the area of protein nutrition and malnutrition in CKD and ESRD. Management recommendations are summarized. Thorough understanding the pathogenesis and etiology of protein malnutrition in CKD and ESRD patients will undoubtedly facilitate the design and development of more effective strategies to optimize protein nutrition and improve outcomes. |
format | Online Article Text |
id | pubmed-5372871 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-53728712017-04-05 Protein Nutrition and Malnutrition in CKD and ESRD Zha, Yan Qian, Qi Nutrients Review Elevated protein catabolism and protein malnutrition are common in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). The underlying etiology includes, but is not limited to, metabolic acidosis intestinal dysbiosis; systemic inflammation with activation of complements, endothelin-1 and renin-angiotensin-aldosterone (RAAS) axis; anabolic hormone resistance; energy expenditure elevation; and uremic toxin accumulation. All of these derangements can further worsen kidney function, leading to poor patient outcomes. Many of these CKD-related derangements can be prevented and substantially reversed, representing an area of great potential to improve CKD and ESRD care. This review integrates known information and recent advances in the area of protein nutrition and malnutrition in CKD and ESRD. Management recommendations are summarized. Thorough understanding the pathogenesis and etiology of protein malnutrition in CKD and ESRD patients will undoubtedly facilitate the design and development of more effective strategies to optimize protein nutrition and improve outcomes. MDPI 2017-02-27 /pmc/articles/PMC5372871/ /pubmed/28264439 http://dx.doi.org/10.3390/nu9030208 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Zha, Yan Qian, Qi Protein Nutrition and Malnutrition in CKD and ESRD |
title | Protein Nutrition and Malnutrition in CKD and ESRD |
title_full | Protein Nutrition and Malnutrition in CKD and ESRD |
title_fullStr | Protein Nutrition and Malnutrition in CKD and ESRD |
title_full_unstemmed | Protein Nutrition and Malnutrition in CKD and ESRD |
title_short | Protein Nutrition and Malnutrition in CKD and ESRD |
title_sort | protein nutrition and malnutrition in ckd and esrd |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372871/ https://www.ncbi.nlm.nih.gov/pubmed/28264439 http://dx.doi.org/10.3390/nu9030208 |
work_keys_str_mv | AT zhayan proteinnutritionandmalnutritioninckdandesrd AT qianqi proteinnutritionandmalnutritioninckdandesrd |