Recent epidemiologic studies have suggested that both increased serum levels of leptin and inflammation may reduce nutrient intake and contribute to the development of protein-energy malnutrition. The nutrient intake of patients receiving maintenance dialysis also is often inadequate, and several lines of evidence suggest that toxins that accumulate with renal failure suppress appetite and contribute to nutritional decline once patients are on maintenance dialysis. Evidence indicates that nutritional decline begins even when the reduction in glomerular filtration rate is modest, and it is likely that the observed decrease in dietary protein and energy intake plays an important role. There are many causes of protein-energy malnutrition in maintenance dialysis patients. This is a problem of substantial importance because many measures of nutritional status correlate with the risk of morbidity and mortality. ▪ AbstractAbout 40% of patients undergoing maintenance dialysis suffer from varying degrees of protein-energy malnutrition.
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