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Title: A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease
Authors: Fouque, D.
Kalantar-Zadeh, K.
Kopple, J.
Cano, N.
Chauveau, P.
Cuppari, Lilian [UNIFESP]
Franch, H.
Guarnieri, G.
Ikizler, T. A.
Kaysen, G.
Lindholm, B.
Massy, Z.
Mitch, W.
Pineda, E.
Stenvinkel, P.
Trevinho-Becerra, A.
Wanner, C.
Univ Lyon 1
Univ Calif Los Angeles
CRNH Auvergne
CHU Bordeaux
Universidade Federal de São Paulo (UNIFESP)
Emory Univ
Univ Trieste
Vanderbilt Univ
Univ Calif Davis
Karolinska Inst
Baylor Coll Med
Univ Nacl Autonoma Mexico
Univ Hosp
Keywords: malnutrition
protein-energy wasting
kidney disease wasting
Issue Date: 1-Feb-2008
Publisher: Nature Publishing Group
Citation: Kidney International. New York: Nature Publishing Group, v. 73, n. 4, p. 391-398, 2008.
Abstract: The recent research findings concerning syndromes of muscle wasting, malnutrition, and inflammation in individuals with chronic kidney disease (CKD) or acute kidney injury (AKI) have led to a need for new terminology. To address this need, the International Society of Renal Nutrition and Metabolism (ISRNM) convened an expert panel to review and develop standard terminologies and definitions related to wasting, cachexia, malnutrition, and inflammation in CKD and AKI. the ISRNM expert panel recommends the term 'protein-energy wasting' for loss of body protein mass and fuel reserves. 'Kidney disease wasting' refers to the occurrence of protein-energy wasting in CKD or AKI regardless of the cause. Cachexia is a severe form of protein-energy wasting that occurs infrequently in kidney disease. Protein-energy wasting is diagnosed if three characteristics are present (low serum levels of albumin, transthyretin, or cholesterol), reduced body mass (low or reduced body or fat mass or weight loss with reduced intake of protein and energy), and reduced muscle mass (muscle wasting or sarcopenia, reduced mid-arm muscle circumference). the kidney disease wasting is divided into two main categories of CKD- and AKI-associated protein-energy wasting. Measures of chronic inflammation or other developing tests can be useful clues for the existence of protein-energy wasting but do not define protein-energy wasting. Clinical staging and potential treatment strategies for protein-energy wasting are to be developed in the future.
ISSN: 0085-2538
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