Malnutrition in hemodialysis patients: what therapy?
Malnutrition is common in hemodialysis patients and is a powerful predictor of morbidity and mortality. Although much progress has been made in recent years in identifying the causes and pathogenesis of malnutrition in hemodialysis patients, as well as recognizing the link between malnutrition and morbidity and mortality, no consensus has been reached concerning its management. Along with such conventional interventions as nutritional counseling, oral nutritional supplements, and intradialytic parenteral nutrition, novel preventive and therapeutic strategies have been tested, such as appetite stimulants, growth hormone, androgenic anabolic steroids, and anti-inflammatory drugs, with contradictory and nonconclusive results. Malnutrition still remains a great challenge for nephrologists in the third millennium.
Bossola
Maurizio
M
Istituto di Clinica Chirurgica, Università Cattolica del Sacro Cuore, Rome, Italy. maubosso@tin.it
Muscaritoli
Maurizio
M
Tazza
Luigi
L
Giungi
Stefania
S
Tortorelli
Antonio
A
Rossi Fanelli
Filippo
F
Luciani
Giovanna
G
D000138:Acidosis / Q000188:drug therapy / Q000209:etiology / Q000628:therapy; D045930:Anabolic Agents / Q000627:therapeutic use; D019167:Appetite Stimulants / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003376:Counseling; D018753:Diet, Protein-Restricted; D019587:Dietary Supplements; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000209:etiology; D007334:Insulin-Like Growth Factor I / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000178:diet therapy / Q000378:metabolism / Q000628:therapy; D044342:Malnutrition / Q000178:diet therapy / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D018529:Nutritional Support; D016226:Phosphorus, Dietary / Q000008:administration & dosage; D011502:Protein-Energy Malnutrition / Q000178:diet therapy / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D006435:Renal Dialysis / Q000009:adverse effects*
D045930:Anabolic Agents; D019167:Appetite Stimulants; D016226:Phosphorus, Dietary; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I