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2018 ; 6
(ä): 161
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Malnutrition in Chronic Kidney Disease
#MMPMID29974043
Iorember FM
Front Pediatr
2018[]; 6
(ä): 161
PMID29974043
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Patients with chronic kidney disease are at substantial risk for malnutrition,
characterized by protein energy wasting and micronutrient deficiency. Studies
show a high prevalence rate of malnutrition in both children and adults with
chronic kidney disease. Apart from abnormalities in growth hormone-insulin like
growth factor axis, malnutrition also plays a role in the development of stunted
growth, commonly observed in children with chronic kidney disease. The pathogenic
mechanisms of malnutrition in chronic kidney disease are complex and involve an
interplay of multiple pathophysiologic alterations including decreased appetite
and nutrient intake, hormonal derangements, metabolic imbalances, inflammation,
increased catabolism, and dialysis related abnormalities. Malnutrition increases
the risk of morbidity, mortality and overall disease burden in these patients.
The simple provision of adequate calorie and protein intake does not effectively
treat malnutrition in patients with chronic kidney disease owing to the intricate
and multifaceted derangements affecting nutritional status in these patients. A
clear understanding of the pathophysiologic mechanisms involved in the
development of malnutrition in chronic kidney disease is necessary for developing
strategies and interventions that are effective, and capable of restoring normal
development and mitigating negative clinical outcomes. In this article, a review
of the pathophysiologic mechanisms of malnutrition in chronic kidney disease is
presented.