| Fighting protein-energy wasting in chronic kidney disease: a challenge of complexity. | |
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MedLine Citation:
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PMID: 21195908 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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Chronic uremia is often characterized by wasting of muscle and fat mass, which has been defined as protein-energy wasting (PEW), and is responsible for substantial worsening of patient outcome in terms of morbidity and mortality, mostly from cardiovascular events. Despite major advances in patient treatment, nutritional outcome in patients with end-stage renal disease has not improved substantially in recent years. Extensive research in this field has provided plausible explanations for this limitation by indicating that the pathogenesis of PEW in kidney disease is complex and multifactorial. Complexity involves underlying metabolic alterations, including inflammation, oxidative stress, and insulin resistance. In addition, patient heterogeneity is increasing with large numbers of obese individuals as a result of the ongoing obesity epidemics. Several tissues are involved in cross-talk and contribute to metabolic derangements, including adipose tissue, the gut, and the central nervous system, with novel mediators including the gastric hormone ghrelin. Acknowledging its complex pathogenesis may favor the development of novel and more effective therapeutic tools for PEW. These should ideally be effective in treating the underlying common mechanisms of wasting, which appear to include oxidative stress, inflammation, and insulin resistance. |
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Authors:
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Gianfranco Guarnieri; Rocco Barazzoni |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation Volume: 21 ISSN: 1532-8503 ISO Abbreviation: J Ren Nutr Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-01-03 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9112938 Medline TA: J Ren Nutr Country: United States |
Other Details:
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Languages: eng Pagination: 2-6 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Medical, Technological and Translational Sciences, Clinica Medica, University of Trieste, Ospedale Cattinara, Strada di Fiume 447, Trieste, Italy. guarnier@units.it |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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