Document Detail


Mechanisms of loss of lean body mass in patients on chronic dialysis.
MedLine Citation:
PMID:  8894134     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients on chronic dialysis treatment often have reduced lean body mass. Certain aspects of bio-incompatibility in dialysis can be viewed as leading to a chronic inflammatory state. In most chronic inflammatory diseases, loss of mean body mass is independent of reduced caloric intake. However, reduced caloric intake accounts for most of the weight loss in these patients and also dialysis patients. Refeeding is associated with increased fat deposition more than restoration of muscle mass. In addition to reduced caloric intake, patients with rheumatoid arthritis, a classic example of a chronic inflammatory disease, have an elevated resting energy expenditure associated with decreased lean body mass. Elevated cellular tumor necrosis factor (TNF) and IL-1 beta production can be demonstrated in these patients. However, in many dialysis patients, increased cytokine production can be 'normal' or reduced. This takes place as the level of malnutrition increases. Thus, cytokines such as IL-1 and TNF play a decreasing role in the pathogenesis of loss of body mass as malnutrition increases and curtails the synthesis of cytokines. Similar to patients with AIDS, progressive disease in patients on chronic dialysis may exhibit subclinical malnutrition which leads to decreased cytokine production. Reduction in cytokine production can be viewed as a protective mechanism.
Authors:
C A Dinarello; R A Roubenoff
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Blood purification     Volume:  14     ISSN:  0253-5068     ISO Abbreviation:  Blood Purif.     Publication Date:  1996  
Date Detail:
Created Date:  1997-03-11     Completed Date:  1997-03-11     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8402040     Medline TA:  Blood Purif     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  388-94     Citation Subset:  IM    
Affiliation:
Department of Medicine, Tufts University, Boston, Mass., USA.
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MeSH Terms
Descriptor/Qualifier:
Biological Factors / metabolism
Body Constitution / physiology*
Body Mass Index
Energy Intake
Humans
Muscle Proteins / metabolism
Muscles / pathology*
Renal Dialysis / adverse effects*
Weight Loss / physiology*
Grant Support
ID/Acronym/Agency:
AI 15614/AI/NIAID NIH HHS; DK-08443/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Biological Factors; 0/Muscle Proteins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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