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Pathogenesis and treatment of malnutrition in maintenance hemodialysis patients

Srinivasan Beddhu, MD
Monique E Cho, MD
Shweta Bansal, MD, FASN
Section Editor
Steve J Schwab, MD
Deputy Editor
Alice M Sheridan, MD


Measures of protein and energy stores such as body size [1-7], muscle mass [8,9], fat mass [8,9], serum albumin [10-12], and cholesterol [13] levels are strong predictors of survival in dialysis patients.

In 2009, the International Society of Renal Nutrition and Metabolism (ISRNM) recommended the term protein-energy wasting (PEW) syndrome to describe the loss of body protein mass and fuel reserves in dialysis patients [14]. The ISRNM developed objective criteria for the definition of PEW syndrome in dialysis and chronic kidney disease (CKD) patients [14].

This topic reviews the pathogenesis and treatment of PEW syndrome in hemodialysis patients.

The assessment of nutritional status and the effect of malnutrition on outcomes among hemodialysis patients are discussed elsewhere. (See "Assessment of nutritional status in hemodialysis patients" and "Patient survival and maintenance dialysis".)

The assessment, prevention, and treatment of malnutrition among patients on maintenance continuous peritoneal dialysis is discussed elsewhere. (See "Nutritional status and protein intake in peritoneal dialysis patients".)

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Literature review current through: Dec 2017. | This topic last updated: Jan 12, 2017.
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