| [ Summary ] |
Protein-energy wasting (PEW) has been shown to be highly prevalent and associated with increased morbidity and mortality in patients with chronic kidney disease. It is thought that PEW is an important cause of sarcopenia and frailty. PEW is believed to result from inadequate protein and energy intake, chronic inflammation, endocrine disorders, metabolic acidosis, loss of nutrient into the dialysate, and dialysis-induced catabolism. A variety of methods are available for the assessment of nutritional status in dialysis patients, including assessment of food intake, physical examination, anthropometry, laboratory tests, and nutritional scoring systems. Because foods high in protein are a main source of dietary phosphorus, imposing dietary phosphorus restriction is often associated with a reduction in dietary protein intake and can lead to PEW. It has been reported that there is an association between low phosphorus concentrations and higher mortality in dialysis patients. This association may be due to a reduced protein intake and worsening nutritional status for patients with hypophosphatemia. |