Inflammation and cachexia in chronic kidney disease.
Chronic inflammation is associated with cachexia and increased mortality risk in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). Inflammation suppresses appetite and causes the loss of protein stores. In CKD patients, increased serum levels of pro-inflammatory cytokines may be caused by reduced renal function, volume overload, oxidative or carbonyl stress, decreased levels of antioxidants, increased susceptibility to infection in uremia, and the presence of comorbid conditions. Cachexia is brought about by the synergistic combination of a dramatic decrease in appetite and an increase in the catabolism of fat and lean body mass. Pro-inflammatory cytokines act on the central nervous system to alter appetite and energy metabolism and to provide a signal-through the nuclear factor-kappaB and ATP-ubiquitin-dependent proteolytic pathways-that causes muscle wasting. Further research into the molecular pathways leading to inflammation and cachexia may lead to novel therapeutic therapies for this devastating and potentially fatal complication of chronic disease.
Cheung
Wai W
WW
Division of Pediatrics Nephrology, Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0634, USA.
Paik
Kyung Hoon
KH
Mak
Robert H
RH
D002100:Cachexia / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D002908:Chronic Disease; D016207:Cytokines / Q000378:metabolism; D001068:Feeding and Eating Disorders / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D007249:Inflammation / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D020738:Leptin / Q000378:metabolism; D009133:Muscular Atrophy / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D009479:Neuropeptides / Q000378:metabolism
D016207:Cytokines; D020738:Leptin; D009479:Neuropeptides