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Wasting in Chronic Kidney Disease – a Complex Issue

Slee, AD; Reid, J; (2018) Wasting in Chronic Kidney Disease – a Complex Issue. JCSM Clinical Reports , 3 (2) pp. 1-10. 10.17987/jcsm-cr.v3i2.63. Green open access

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Abstract

Chronic kidney disease (CKD) has become a global health burden and is associated with increased morbidity and mortality. In particular, wasting is highly prevalent in later stages of the illness with muscle loss being a common problem. The aetiology and progression of this wasting is complex and multiple states have been identified linked to wasting in CKD. These include: ‘malnutrition’, ‘disease‐related malnutrition’, ‘protein‐energy wasting’, ‘cachexia’, ‘sarcopenia’, ‘frailty’ and ‘muscle wasting‘. The purpose of this paper is to review these terms in the context of CKD. Common features include weight loss, loss of muscle mass and muscle function principally driven by CKD disease specific factors and inflammatory mediators. Disease‐related malnutrition would appear to be a more appropriate term for CKD than malnutrition as it take in to consideration disease specific factors such as inflammation for example. Frailty is commonly associated with age‐related decline in physiological function. Development of novel screening tools measuring across multiple domains of nutritional status, muscle and physical function may be useful in CKD. Research into potential treatments are currently underway with focus on multi‐modal therapies including nutrition, resistance training and anabolic drugs such as myostatin blockade and selective androgen receptor modulators. A better understanding of different states and terms may help guide assessment and treatment opportunities for patients.

Type: Article
Title: Wasting in Chronic Kidney Disease – a Complex Issue
Open access status: An open access version is available from UCL Discovery
DOI: 10.17987/jcsm-cr.v3i2.63
Publisher version: https://onlinelibrary.wiley.com/doi/full/10.17987/...
Language: English
Additional information: Copyright © 2018 The Authors. Journal of Cachexia, Sarcopenia and Muscle ‐ Clinical Reports published on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: Chronic kidney disease, Protein‐energy wasting, Cachexia, Sarcopenia, Frailty, Muscle wasting disease
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Department of Education
URI: https://discovery.ucl.ac.uk/id/eprint/10112946
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