title: Etiology of the protein-energy wasting syndrome in chronic kidney disease: a consensus statement from the International Society of Renal Nutrition and Metabolism (ISRNM).
abstract: Protein-energy wasting (PEW), a term proposed by the International Society of Renal Nutrition and Metabolism (ISRNM), refers to the multiple nutritional and catabolic alterations that occur in chronic kidney disease (CKD) and associate with morbidity and mortality. To increase awareness, identify research needs, and provide the basis for future work to understand therapies and consequences of PEW, ISRNM provides this consensus statement of current knowledge on the etiology of PEW syndrome in CKD. Although insufficient food intake (true undernutrition) due to poor appetite and dietary restrictions contribute, other highly prevalent factors are required for the full syndrome to develop. These include uremia-induced alterations such as increased energy expenditure, persistent inflammation, acidosis, and multiple endocrine disorders that render a state of hypermetabolism leading to excess catabolism of muscle and fat. In addition, comorbid conditions associated with CKD, poor physical activity, frailty, and the dialysis procedure per se further contribute to PEW.
authors: Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Solna, Sweden.
authors: Juan Jesús
authors: JJ
authors: Carrero
authors: Peter
authors: P
authors: Stenvinkel
authors: Lilian
authors: L
authors: Cuppari
authors: T Alp
authors: TA
authors: Ikizler
authors: Kamyar
authors: K
authors: Kalantar-Zadeh
authors: George
authors: G
authors: Kaysen
authors: William E
authors: WE
authors: Mitch
authors: S Russ
authors: SR
authors: Price
authors: Christoph
authors: C
authors: Wanner
authors: Angela Y M
authors: AY
authors: Wang
authors: Pieter
authors: P
authors: ter Wee
authors: Harold A
authors: HA
authors: Franch
mesh_terms: D054392:Adipokines / Q000097:blood; D015897:Comorbidity; D032921:Consensus; D004734:Energy Metabolism; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D008019:Life Style; D009043:Motor Activity; D009752:Nutritional Status; D056128:Obesity, Abdominal / Q000503:physiopathology; D015995:Prevalence; D011502:Protein-Energy Malnutrition / Q000209:etiology* / Q000503:physiopathology; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology; D019282:Wasting Syndrome / Q000209:etiology* / Q000503:physiopathology
chemical_list: D054392:Adipokines