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The presence of malnutrition in chronic kidney disease (CKD) is well-known. The discovery in the last 15 years of pathophysiological mechanisms that lead to this process, such as anorexia, the increase of protein catabolism and inflammation, has created the need for a new name by the International Society of Renal Nutrition and Metabolism (ISRNM): protein-energy wasting syndrome (PEW). This document’s objectives are to propose the use of the term "desgaste proteico energético" (DPE) as a more accurate translation of the English term and to update the pathogenic mechanisms involved that are inherent to DPE (PEW). We simultaneously review the latest epidemiological evidence that highlight the relevance of malnutrition and its impact both on mortality and morbidity in CKD. Finally, we point out the need to redefine DPE (PEW) diagnostic criteria so that they are applicable to the Spanish population with CKD. We do not think that the criteria established by the ISRNM can be extrapolated to different populations, as is the case, for example, with interracial anthropometric differences.
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http://dx.doi.org/10.3265/Nefrologia.pre2014.Apr.12522 | DOI Listing |
Ren Fail
December 2025
Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Background: Protein energy wasting (PEW) is prevalent in adult maintenance hemodialysis (MHD) patients. Concurrently, cardiovascular diseases (CVD) remain a leading cause of mortality in MHD patients. However, the relationship between PEW and CVD in MHD patients remains unclear.
View Article and Find Full Text PDFNutrients
November 2024
Nephrology Department, Hospital Universitari Dr. J Trueta, 17007 Girona, Spain.
Background And Objective: To evaluate the effectiveness and safety of intradialytic parenteral nutrition (IDPN) on different nutritional outcomes.
Methods: This was a retrospective analysis for a "routinely collected data bank" in a multicenter cohort, conducted on consecutive malnourished or at-risk of malnutrition patients with chronic kidney disease on hemodialysis who underwent IDPN with a three-in-one parenteral nutrition formula for a period ≥ 2 weeks. The primary endpoint was the mean change in the malnutrition inflammation score (MIS) score between baseline and the last follow-up visit on IDPN.
Nutrients
November 2024
Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan.
The malnutrition-inflammation score (MIS) is a practical and accessible tool for evaluating protein energy wasting (PEW) in patients on dialysis. However, the severity of PEW at each stage of chronic kidney disease (CKD), especially with late dialysis initiation, is unclear. We evaluated the MIS of 3659 patients with CKD stages 1-5 and the changes in their MIS results at baseline and at the time before dialysis initiation.
View Article and Find Full Text PDFClin Nutr ESPEN
December 2024
UO Nefrologia, Azienda Ospedaliero-Universitaria Parma, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy; Scuola di Specializzazione in Nefrologia, Università di Parma, Dipartimento di Medicina e Chirurgia, Parma, Italy.
Acute kidney injury (AKI) is a complex clinical syndrome characterized by a rapid decline in kidney function, often resulting in complex metabolic and hormonal derangements. A major concern in managing AKI patients is the development of protein energy wasting (PEW), a condition marked by loss of lean body mass and negative impact on overall health outcomes. Additionally, the need of Kidney Replacement Therapy (KRT) for the most severe forms of AKI may further increase the risk of PEW, with a substantial impact on fluid and metabolic balance.
View Article and Find Full Text PDFFront Nutr
November 2024
Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
Background: Exercise and nutritional support are effective strategies in hemodialysis patients who often face health issues like protein-energy wasting (PEW). Therefore, this study aimed to evaluate whether combining exercise with nutritional support offers additional benefits for anthropometry, body composition, and biochemical markers of nutrition in hemodialysis patients.
Methods: This systematic review searched databases, including PubMed, Scopus, and Web of Science, until 14 February 2024 to identify relevant randomized controlled trials.
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