Appetite disorders in uremia.
Patients with chronic kidney disease frequently experience loss of appetite (anorexia), which increases in severity during the progression of the disease and may lead to protein-energy wasting, morbidity, and mortality. Anorexia represents a multiple, complex, and multifactorial disorder that may have its origin in renal failure (contemplating not only retention of uremic toxins but also peptides and cytokines) but that later on also involves metabolic abnormalities not yet corrected by dialysis therapy. This paper reviews current knowledge about the clinical signs of uremic anorexia as well as mechanisms involved. Based on megestrol acetate interventions and the recent observation that sex may modulate uremic appetite behavior, the potential role of sex hormones in treating chronic kidney disease anorexia needs to be further explored.
Carrero
Juan Jesús
JJ
Division of Renal Medicine, CLINTEC, Karolinska Institutet, Stockholm, Sweden. juan.jesus.carrero@ki.se
Aguilera
Abelardo
A
Stenvinkel
Peter
P
Gil
Fernando
F
Selgas
Rafael
R
Lindholm
Bengt
B
D000855:Anorexia / Q000453:epidemiology*; D001066:Appetite; D016207:Cytokines / Q000097:blood; D001068:Feeding and Eating Disorders / Q000453:epidemiology* / Q000503:physiopathology; D006706:Homeostasis; D006801:Humans; D007408:Intestinal Absorption; D020738:Leptin / Q000502:physiology; D009569:Nitric Oxide / Q000502:physiology; D014511:Uremia / Q000150:complications* / Q000503:physiopathology
D016207:Cytokines; D020738:Leptin; D009569:Nitric Oxide