Description
This translational text offers in-depth reviews of the metabolic and nutritional disorders that are prevalent in patients with renal disease. Chapter topics address the growing epidemic of obesity and metabolic syndrome. Each chapter integrates basic and clinical approaches, from cell biology and genetics to diagnosis, patient management and treatment. Chapters in sections 4-7 include new illustrative case reports, and all chapters emphasize key concepts with chapter-ending summaries. New features also include the latest National Kidney Foundation Clinical Practice Guidelines on Nutrition in Chronic Renal Failure, the most recent scientific discoveries and the latest techniques for assessing nutritional status in renal disease, and literature reviews on patients who receive continuous veno-venous hemofiltration with or without dialysis.- Provides a common language for nephrologists, nutritionists, endocrinologists, and other interested physicians to discuss the underlying research and translation of best practices for the nutritional management and prevention of renal disease- Saves clinicians and researchers time in quickly accessing the very latest details on nutritional practice as opposed to searching through thousands of journal articles- Correct diagnosis (and therefore correct treatment) of renal, metabolic, and nutritional disorders depends on a strong understanding of the molecular basis for the disease – both nephrologists and nutritionists will benefit- Nephrologists and nutritionists will gain insight into which treatments, medications, and diets to use based on the history, progression, and genetic make-up of a patient- Case Reports will offer an added resource for fellows, nutritionists, and dieticians who need a refresher course
Table of Contents
Chapter 1. The Influence of Kidney Disease on Protein and Amino Acid MetabolismIntroductionCKD Interrupts the Components of Protein MetabolismDefining Muscle WastingMechanisms of Muscle WastingThe Ubiquitin-Proteasome SystemSynergism of Proteolytic Pathways Causes Muscle Wasting in CKDProteolytic Activities Present in Muscles of PatientsFactors Triggering Muscle Wasting in CKD and Other Catabolic StatesMyostatin and the Regulation of Muscle Protein WastingMyostatin in Muscle Increases in Catabolic ConditionsBeneficial Responses from Blocking Myostatin in Models of Muscle CatabolismBlocking Myostatin can Suppress CKD-Induced Muscle WastingCKD Changes the Concentrations of Certain Amino AcidsLinks Between Amino Acid and Protein MetabolismConclusionReferencesChapter 2. Carbohydrate Metabolism in Kidney Disease and Kidney FailureIntroductionInsulin ResistanceInsulin SecretionInsulin ClearanceHypoglycemiaCarbohydrate Metabolism in Patients with Renal Replacement TherapyTreatment of Diabetes Mellitus in Diabetics with CKDDrug Management in Diabetics with CKD (Figure 2.1)ReferencesChapter 3. Altered Lipid Metabolism and Serum Lipids in Kidney Disease and Kidney FailureIntroductionPlasma Lipid and Lipoprotein Profile in CKD/ESRD PatientsThe Nature and Mechanisms of CKD-Induced Lipid AbnormalitiesThe Nature and Mechanisms of Adverse Effects of Lipid Disorders in CKDTreatment of CKD-Associated DyslipidemiaPotential Adverse Effects of StatinsReferencesChapter 4. Uremic ToxicityIntroductionUremic Symptoms and SignsToxic Effects of Uremic Plasma or SerumDefinition of a Uremic ToxinImpact of Dialysis Treatment on Uremic ToxicityToxicity of Inorganic Substances in UremiaFree Water-Soluble Low-Molecular-Weight SolutesProtein-Bound SolutesMiddle MoleculesGeneral ConclusionsAcknowledgementReferencesChapter 5. Inflammation in Chronic Kidney DiseaseGeneral ConsiderationsMultifactorial Causes of Inflammation in Chronic Kidney DiseaseInflammation as a Cause of Protein-Energy WastingInflammation as a Catalyst of Other Risk FactorsOther Consequences of InflammationMonitoring InflammationTreatment of Inflammation in Chronic Kidney DiseaseReferencesChapter 6. Catalytic (Labile) Iron in Kidney DiseaseIntroductionDefinition of Catalytic (Labile) Iron and its Importance in Tissue InjuryRole of Catalytic Iron in Acute Kidney InjuryGentamicin-Induced Mobilization of Iron From Renal Cortical MitochondriaEvidence Suggesting a Role for Iron in Gentamicin-Induced Acute Renal Failure in RatsCatalytic Iron in Chronic Kidney Disease (Table 6.3)Catalytic Iron in Diabetic NephropathyCatalytic Iron in Chronic Kidney DiseaseConcluding CommentsReferencesChapter 7. Carbonyl Stress in UremiaIntroductionIncreased Age and other Protein ModificationsCarbonyl StressClinical Consequences of Carbonyl StressNutrition and Carbonyl StressReferencesChapter 8. Effect of Acidemia and Alkalemia on Nutrition and MetabolismIntroductionAcute Responses to Acidosis and AlkalosisComparing Effects of Acidemia to those of StarvationEndocrine Responses to AcidemiaCalcium MetabolismProtein MalnutritionMetabolic Acidemia Stimulates the Ubiquitin/Proteasome Proteolytic PathwayClinical Implications of Acidemia for Protein NutritionReferencesChapter 9. Prevention and Management of Cardiovascular Disease in Kidney Disease and Kidney FailureIntroductionCardiovascular Risk FactorsManagement of CVDConclusionReferencesChapter 10. Assessment of Protein and Energy Nutritional StatusIntroductionDefinition of Protein and Energy WastingAssessment of Protein MassAssessment of Protein and Energy HomeostasisSummary and RecommendationsReferencesChapter 11.
