Malnutrition-inflammation-atherosclerosis syndrome in Chronic Kidney disease |
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Authors: | Pragna Rao G C Reddy A S Kanagasabapathy |
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Institution: | (1) Department of Biochemistry, Kamineni Institute of Medical Sciences, Narketpally, AP 508254, India;(2) Kamineni Hospitals, Hyderabad, 500068, India;(3) Kamineni Hospitals, LB Nagar, Hyderabad, 500068, India |
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Abstract: | Chronic kidney disease is becoming a major health problem globally and in India an alarming number of about 8 million people
are suffering from this disease. Patients undergoing hemodialysis have a high prevalence of protein-energy malnutrition and
inflammation. As these two conditions often occur concomitantly in hemodialysis patients, they have been referred together
as ‘malnutrition-inflammation-atherosclerosis syndrome’ to emphasize the important association with atherosclerotic cardiovascular
disease. The three factors related to the pathophysiology in these patients are dialysis related nutrient loss, increased
protein catabolism and hypoalbuminemia. Inflammation in Chronic Kidney disease is the most important factor in the genesis
of several complications in renal disease. Pro-inflammatory cytokines like IL-1 and TNF-alpha play a major role in the onset
of metabolic alterations in Chronic Kidney disease patients. Atherosclerosis is a very frequent complication in uremia due
to the coexistence of hypertension, hyperhomocysteinemia, inflammation, malnutrition and increased oxidative stress, generation
of advanced glycation end products, advanced oxidation protein products, hyperlipidemia and altered structural and functional
ability of HDL. LDL-cholesterol, apolipoprotein (A), apolipoprotein (B), and Lp(a) are also associated with atherosclerosis.
Studies have now provided enormous data to enable the evaluation of the severity of malnutrition-inflammation-atherosclerosis
syndrome as well as effective monitoring of these patients. |
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Keywords: | Chronic Kidney Disease Hemodialysis Malnutrition Inflammation Atherosclerosis Syndrome |
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