Inflammation and nutrition in renal insufficiency.

摘要: Protein-energy malnutrition (PEM) and inflammation are common in patients with chronic kidney disease (CKD) worsen as the CKD progresses toward end-stage renal (ESRD). These conditions major predictors of poor clinical outcome failure, reflected by a strong association between hypoalbuminemia cardiovascular (CVD). It has been suggested that is cause both PEM CVD and, hence, main link among these conditions, but hypotheses not well established. Increased release or activation inflammatory cytokines, such interleukin-6 tumor necrosis factor alpha, may suppress appetite, muscle proteolysis hypoalbuminemia, be involved atherogenesis. Increasing serum levels proinflammatory cytokines caused reduced function, volume overload, oxidative carbonyl stress, decreased antioxidants, increased susceptibility to infection uremia, presence comorbid lead patients. In hemodialysis patients, exposure dialysis tubing membranes, quality water, back-filtration back-diffusion contaminants, foreign bodies access maybe additional causes inflammation. Similarly, episodes overt latent peritonitis, peritoneal (PD) catheter its related infections, constant PD solution contribute The degree which clear. Because strongly associated each other can change many nutritional measures concurrently same direction, terms malnutrition-inflammation complex syndrome (MICS) and/or malnutrition-inflammation-atherosclerosis (MIA) have denote important contribution outcome. Maintenance who underweight low cholesterol, creatinine, homocysteine suffering from MICS/MIA subsequent Consequently, obesity hypercholesterolemia appear protective, known reverse epidemiology. Although significant reversing traditional risk factors it clear whether their complications effectively managed ESRD management improves