Impact of inflammation on nutrition, iron status, and erythropoietin responsiveness in ESRD patients.
Since many end stage renal disease (ESRD) patients experi inflammation, malnutrition, and anemia, the interplay of these processes should be considered in the approach to patients treated with erythropoietin (EPO). This article reviews the interrelationship between these factors. The systemic inflammatory response caused by exposure to inflammatory stimuli results in anorexia and metabolic disturbances leading to protein calorie malnut tion as well as sequestration of iron and hyporesponsiveness to EPO. The implications of these effects and possible strategies to optimize anemia management in the presence of these conditions are discussed.
Bistrian
B R
BR
Laboratory Nutrition and Infection, Division of Clinical Nutrition, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Carey
L A
LA
D018798:Anemia, Iron-Deficiency / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism; D002985:Clinical Protocols; D016903:Drug Monitoring / Q000379:methods; D004921:Erythropoietin / Q000627:therapeutic use*; D005293:Ferritins / Q000097:blood; D006397:Hematinics / Q000627:therapeutic use; D006801:Humans; D007501:Iron / Q000378:metabolism; D033862:Iron-Binding Proteins / Q000378:metabolism; D007505:Iron-Dextran Complex / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000378:metabolism / Q000628:therapy; D009752:Nutritional Status; D018529:Nutritional Support; D011502:Protein-Energy Malnutrition / Q000209:etiology* / Q000378:metabolism / Q000628:therapy; D012307:Risk Factors; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology* / Q000378:metabolism / Q000628:therapy; D016896:Treatment Outcome
D006397:Hematinics; D033862:Iron-Binding Proteins; D004921:Erythropoietin; D007505:Iron-Dextran Complex; D005293:Ferritins; D007501:Iron