| [ Summary ] |
Anorexia and wasting are common complications in uremic or dialysed patients. It has been reported that there is a strong association between clinical outcomes and malnutrition. There are many causes of anorexia, wasting or malnutrition in these patients. Important factors include middle molecular uremic toxins, carnitine, leptin, cholecystokinin (CCK), neuropeptide Y (NPY) or inflammatory cytokines (interleukin-6 ; IL-6 , tumor necrosis factor alfa ; TNF α), insulin-like growth factor (IGF-1). Serum levels of uremic toxins (molecular weight range : 1.0 to 5.0 kD), leptin, CCK, IL-6, TNF α are elevated because of degradation of renal clearance. The levels of carnitine, NPY or IGF-1 decline because of dietary restrictions or loss through dialysis sessions. These factors induce anorexia, impaired gastric emptying and malnutrition. |