Theme |
Metabolic Syndrome in Chronic Renal Failure |
Title |
Therapeutic strategy for metabolic syndrome in ESRD : body weight control, exercise and diet therapy |
Author |
Takehiko Miyaji |
Division of Nephrology, Shizuoka Saiseikai General Hospital |
Author |
Akihiko Kato |
Division of Blood Purification, Hamamatsu University School of Medicine |
[ Summary ] |
The prevalence of obesity is gradually increasing in Japanese dialysis patients. However, a higher body mass index (BMI) has been demonstrated to be associated with better survival rates, while patients with a lower BMI have lower survival rates when undergoing hemodialysis (HD). This situation may be termed “reverse epidemiology”. Therefore, it remains uncertain whether traditional lifestyle intervention such as dietary and exercise therapy may be truly useful in preventing cardiovascular events and death in obese HD patients. Appropriate exercise and dietary sodium restriction is well known to improve the prognosis for HD patients. In contrast, there is a possibility that strict energy restriction and body weight control may somewhat provoke energy-protein malnutrition. Therefore, physicians should be aware of these risks and how they apply to obese HD patients. |