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Inflammation and cachexia in chronic kidney disease

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Abstract

Chronic inflammation is associated with cachexia and increased mortality risk in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). Inflammation suppresses appetite and causes the loss of protein stores. In CKD patients, increased serum levels of pro-inflammatory cytokines may be caused by reduced renal function, volume overload, oxidative or carbonyl stress, decreased levels of antioxidants, increased susceptibility to infection in uremia, and the presence of comorbid conditions. Cachexia is brought about by the synergistic combination of a dramatic decrease in appetite and an increase in the catabolism of fat and lean body mass. Pro-inflammatory cytokines act on the central nervous system to alter appetite and energy metabolism and to provide a signal—through the nuclear factor-κB and ATP-ubiquitin-dependent proteolytic pathways—that causes muscle wasting. Further research into the molecular pathways leading to inflammation and cachexia may lead to novel therapeutic therapies for this devastating and potentially fatal complication of chronic disease.

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Acknowledgments

This work was supported by the Amgen Young Investigator Grant of the National Kidney Foundation to WC and grants from the National Institute of Health (K24 DK59574), Baxter Renal Discovery Program, and the Satellite Foundation to RM. KHP was supported by a grant from Korean Society of Pediatric Nephrology.

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The authors declare that no conflict of interest exists.

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Authors and Affiliations

  1. Division of Pediatrics Nephrology, Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, MC0634, La Jolla, CA, 92093-0634, USA

    Wai W. Cheung & Robert H. Mak

  2. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Kyung Hoon Paik

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  1. Wai W. Cheung
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  2. Kyung Hoon Paik
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  3. Robert H. Mak
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Correspondence to Robert H. Mak.

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Cheung, W.W., Paik, K.H. & Mak, R.H. Inflammation and cachexia in chronic kidney disease. Pediatr Nephrol 25, 711–724 (2010). https://doi.org/10.1007/s00467-009-1427-z

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  • DOI: https://doi.org/10.1007/s00467-009-1427-z

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