| [ Summary ] |
The International Society of Renal Nutrition and Metabolism expert panel has developed standard terminologies and definitions related to wasting, cachexia, malnutrition, and inflammation in chronic kidney disease（CKD）. The expert panel recommends the term "protein-energy wasting (PEW)" to describe the syndrome of protein mass depletion and/or depletion of energy sources （that is, body protein and fat masses）. This abnormality is often related to not only inflammation, but also catabolic illness, nutrient loss into dialysates, metabolic acidosis, and endocrine disorders. The expert panel also advocates that four main established categories be recognized for the diagnosis of PEW. Biochemical tests may be used along with other measures to determine reduced body weight, or body fat mass, decreases in muscle mass or low energy and protein intake. However, the actual prevalence of PEW remains to be determined in stage 4 and 5 CKD patients. The novel terminology associated with PEW has recently been established and it is hoped that a systematically defined diagnostic criteria will clarify the prevalence of PEW and enhance the effectiveness of CKD patient care. |