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Pathophysiological and clinical aspects of malnutrition in chronic renal failure

Published online by Cambridge University Press:  14 December 2007

G. Caimi ,
C. Carollo  and
R. Lo Presti
G. Caimi*
Affiliation:
Via Leonardo da Vinci 52, 90145 Palermo, Italy Department of Internal Medicine, Cardiovascular and Renal Diseases, Università di Palermo, Palermo, Italy
C. Carollo
Affiliation:
Department of Internal Medicine, Cardiovascular and Renal Diseases, Università di Palermo, Palermo, Italy
R. Lo Presti
Affiliation:
Department of Internal Medicine, Cardiovascular and Renal Diseases, Università di Palermo, Palermo, Italy
*
*Corresponding author: Professor Gregorio Caimi, fax +39 91 6554535, email caimigre@unipa.it
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Abstract

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Kidney diseases are the ninth leading cause of death in the USA. In these patients cardiovascular mortality is greater than in the general population. This observation, not completely explained by the so-called ‘traditional’ cardiovascular risk factors, lead the authors to postulate other ‘emerging’ ones found in chronic renal failure patients. Among these new findings, nutritional status, considered as the balance existing between nutrient requirements and intakes, plays an important role for the development of cardiovascular diseases. In fact several nutritional parameters are widely known as pathophysiological determinants of cardiovascular disturbances, which are based on accelerated atherosclerosis, due especially to enhanced oxidative stress and endothelial dysfunction. Chronic renal failure is a clinical condition that from many points of view seems to be a chronic inflammatory state, and many studies confirm this observation. This influences nutritional status especially in dialysis patients. Malnutrition is related in turn to accelerated atherosclerosis thus leading to a postulated ‘malnutrition, inflammation, atherosclerosis’ (MIA) syndrome in which malnutrition, inflammation and atherosclerosis contribute to an elevated cardiovascular mortality rate. The present review explores this issue, first by describing epidemiological aspects of malnutrition in chronic renal failure patients and then by analysing the specific biochemical and metabolic features of these patients.

Keywords

Chronic renal failureKidney diseaseAtherosclerosisMalnutrition
Type
Research Articles
Information
Nutrition Research Reviews , Volume 18 , Issue 1 , June 2005 , pp. 89 - 97
Copyright
Copyright © The Authors 2005

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