| Theme | Emaciation in Chronic Dialysis Patients | |
|---|---|---|
| Title | The mechanisms of leanness in chronic renal failure and hemodialysis patients | |
| Publish Date | 2000/04 | |
| Author | Akihiko Kato | Department of Medicine, Maruyama Hospital |
| Author | Mari Odamaki | First Department of Medicine, Hamamatsu University School of Medecine |
| [ Summary ] | Patients with advanced renal failure and dialysis are often become lean. The leanness in these patients is due to energy and protein malnutrition, inflammation and metabolic acidosis. Recently, leptin, a peptide hormone produced by adipocytes, has come to be thought of as an appetite inhibitor. Since blood concentrations of leptin in chronic renal failure (CRF) and dialysis patients increase about 3-fold compared to healthy subjects, high circulating leptin may contribute to anorexia and malnutrition in these patients. Inflammatory cytokines also contribute to the development of malnutrition in hemodialysis patients. This is especially, so in cases where high serum levels of interleukin (IL)-6 and tumor necrosis (TNF)-alpha are reported to be associated with malnutrition in dialysis patients. Serum soluble TNF-alpha level (p80) is also associated with hypoalbuminemia. Metabolic acidosis can cause degradation of amino acids and proteins, and induce leanness in CRF and hemodialysis patients. Since high-flux dialyzer membranes can remove these circulatingcytokines and leptins, the usage of these membranes may be effective for the treatment of malnutrition in hemodialysis patients. |
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