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      Risk of Mortality in Patients with End-Stage Renal Disease: The Role of Malnutrition and Possible Therapeutic Implications

      review-article
      Hormone Research in Paediatrics
      S. Karger AG
      End-stage renal disease, Malnutrition, Mortality, Growth hormone, Dialysis

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          Abstract

          The mortality rate of dialysis patients is still considerably high. Beside the traditional risk factors, specific uremia-related risk factors are identified. Among them, hypoalbuminemia and malnutrition have a strong association to mortality in chronic dialysis patients. Various studies document a strong relation between reduced calorie and protein uptake and mortality in uremic patients. Several factors responsible for malnutrition in dialysis patients have been identified. These factors may be dialysis-associated, due to intercurrent illnesses or are associated with uremic complications (e.g. hyperparathyroidism, anemia, acidosis, etc.). Malnutrition is treatable and can be avoided by several means. Beside the increase in the dose of dialysis and adequate protein and calorie intake, intradialytic nutrition is an additional choice. The combination with specific drugs (e.g. growth hormone) may potentiate the success of the modified treatment modalities, particularly in patients who need nutritional support during an intercurrent illness. Further studies are required to measure the impact of for example growth hormone supplementation on mortality rate and quality of life in malnourished patients on chronic dialysis.

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          Most cited references2

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          Electrocardiogram and Outcome following Renal Transplantation

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            The Threat of Infectious Diseases in Somalia

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              Author and article information

              Journal
              HRE
              Horm Res Paediatr
              10.1159/issn.1663-2818
              Hormone Research in Paediatrics
              S. Karger AG
              978-3-8055-7523-2
              978-3-318-00931-6
              1663-2818
              1663-2826
              2002
              November 2002
              17 November 2004
              : 58
              : Suppl 3
              : 30-34
              Affiliations
              Department of Medicine, Division of Nephrology, University of Heidelberg, Germany
              Article
              66486 Horm Res 2002;58(suppl 3):30–34
              10.1159/000066486
              12435894
              f404e982-bd9c-4fc6-a35a-f4d2d64d63e3
              © 2002 S. Karger AG, Basel

              Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

              History
              Page count
              Tables: 5, References: 46, Pages: 5
              Categories
              GH and Kidney

              Endocrinology & Diabetes,Neurology,Nutrition & Dietetics,Sexual medicine,Internal medicine,Pharmacology & Pharmaceutical medicine
              End-stage renal disease,Malnutrition,Dialysis,Mortality,Growth hormone

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