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Kidney insufficiency and nutrient-based modulation of inflammation
Kamyar Kalantar-Zadeh1, Peter Stenvinkel, Rachelle Bross
1Division of Nephrology and Hypertension, Harbor-UCLA Campus, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA. kamkal@ucla.edu
Summary
The malnutrition-inflammation complex syndrome contributes to high cardiovascular mortality in chronic kidney disease patients. Addressing this multifactorial condition requires combined interventions, as single treatments are insufficient.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Nutritional Science
Background:
- Chronic kidney disease (CKD) patients face high cardiovascular mortality.
- Protein-energy malnutrition and inflammation (malnutrition-inflammation complex syndrome) are prevalent in CKD and linked to mortality.
Purpose of the Study:
- Review the pathophysiology of the malnutrition-inflammation complex syndrome in CKD.
- Explore potential dietary and nutritional interventions for this syndrome.
Main Methods:
- Literature review of the malnutrition-inflammation complex syndrome in CKD.
- Analysis of existing epidemiological and theoretical data on nutritional modulation.
Main Results:
- The malnutrition-inflammation complex syndrome drives atherosclerotic cardiovascular disease in CKD.
- A 'reverse epidemiology' of cardiovascular risk factors is observed in CKD.
- Anorexia, low nutrient intake, and oxidative stress are potential targets for dietary intervention.
Conclusions:
- No consensus exists on correcting the malnutrition-inflammation complex syndrome in CKD.
- Multifactorial nature necessitates simultaneous interventions.
- Urgent need for clinical trials to improve outcomes in CKD patients.