The role of oxidative stress in the development of protein-energy wasting and sarcopenia in patients with stage 5D chronic kidney disease

Nephrology ◽  
2021 ◽  
Vol 2_2021 ◽  
pp. 41-46
Author(s):  
M.Z. Gasanov Gasanov ◽  
V.M. Negoda Negoda ◽  
M.M. Batyushin Batyushin ◽  
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...  
2021 ◽  
Vol 11 (5) ◽  
pp. 370-379
Author(s):  
M. Z. Gasanov ◽  
M. N. Kolomyitseva ◽  
M. M. Batyushin

In recent decades, the prevalence of chronic kidney disease (CKD) in the population has a clear upward trend. This is due, first of all, to an increase in the frequency of occurrence of the main factors leading to its development: diabetes mellitus and arterial hypertension. The progression of CKD against the background of the action of these factors leads to a steady loss of the kidneys of their filtration capacity and the development of complications associated with this process. These include, first of all, metabolic and acid-base disorders, electrolyte abnormalities, uremic intoxication, overhydration, protein-energy wasting, sarcopenia and others. Most of them are involved in the development of endothelial dysfunction and the formation of cardiovascular remodeling (CVR), as a key component of the cardiorenal continuum. At the same time, there is a mutual negative influence of pathology of the cardiovascular system on renal function and manifestations of CKD on cardiovascular hemodynamics. This “vicious circle” leads to the development of end-stage renal disease and an increase in cardiovascular risk and mortality from diseases of the circulatory system in patients with advanced stages of CKD. In this connection, this work is devoted to the study of the role of uremic intoxication and, in particular, indoxyl sulfate, in the development of CVR in patients with CKD at different stages of the disease. 


Author(s):  
Juan Jesús Carrero ◽  
Peter Stenvinkel

Low-grade persistent inflammation is a common feature of chronic kidney disease. This chapter provides an overview of the pathogenesis and clinical consequences of elevated pro-inflammatory cytokines in the uraemic milieu with an emphasis on dialysis stages. It reviews the multifactorial dialysis- and non-dialysis-related causes of inflammation and its purported role in the development of protein energy wasting, vascular calcification, endocrine disorders, and depression. The chapter also discusses the use and the need of monitoring C-reactive protein levels regularly in the clinical setting and comments on possible therapeutic approaches to reduce inflammation in these patients.


2018 ◽  
Vol 234 (7) ◽  
pp. 11411-11423 ◽  
Author(s):  
Mohammad Khabbaz Shirazi ◽  
Asaad Azarnezhad ◽  
Mohammad Foad Abazari ◽  
Mansour Poorebrahim ◽  
Pegah Ghoraeian ◽  
...  

2019 ◽  
Vol 49 (1-2) ◽  
pp. 202-211 ◽  
Author(s):  
Ramy M. Hanna ◽  
Lena Ghobry ◽  
Olivia Wassef ◽  
Connie M. Rhee ◽  
Kamyar Kalantar-Zadeh

Objectives of Review: Protein-energy wasting (PEW) is a state of disordered catabolism resulting from metabolic and nutritional derangements in chronic disease states. Patients with chronic kidney disease (CKD), and end-stage renal disease (ESRD) in particular, have muscle wasting, sarcopenia, and cachexia that contribute to frailty and morbidity. Moreover, reverse epidemiology findings have strongly linked PEW with mortality in CKD and ESRD. Updated Findings: The malnutrition-inflammation score (KALANTAR Score) provides a useful tool to predict nutritional risk. A stronger focus on renal nutrition in renal patients is needed to attenuate cachexia and muscle loss. Malnutrition is a far greater threat in patients with renal disease than obesity, which means dietary counseling needs to be tailored to reflect this observation. The need to achieve optimal caloric intake is compounded by the need to limit excess protein intake in CKD, resulting in the need for energy supplementation to avoid PEW. Preventing PEW is the most pressing clinical concern in CKD/ESRD. Other nutritional issues to reckon in renal disease include the need to normalize serum bicarbonate to manage acidosis, uric acid control, and phosphorous control in CKD and ESRD. Exercise maybe beneficial, but further work is needed to prove a conclusive benefit via a randomized trial. Summary: PEW prevention is an integral part of renal nutrition and is of paramount importance given the obesity paradox. Integrative approaches by physicians and dieticians are needed to take a holistic view of a patient’s diet beyond just control of particular laboratory parameters.


Nephrology ◽  
2020 ◽  
Vol 4_2020 ◽  
pp. 60-64
Author(s):  
A.S. Kuzyarovа Kuzyarovа ◽  
M.Z. Gasanov Gasanov ◽  
M.M. Batyushin Batyushin ◽  
K.R. Bogomolova Bogomolova ◽  
I.H. Adamokova Adamokova ◽  
...  

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