Division of Pediatric Nephrology, Rady Children's Hospital, University of California, San Diego, 9500 Gilman Drive, MC 0630, La Jolla, CA, 92093-0630, USA.
Pediatric Nephrourology Division, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.
Pediatr Nephrol. 2018 May;33(5):789-798. doi: 10.1007/s00467-017-3684-6. Epub 2017 May 15.
Loss of lean body mass is a relevant component of the cachexia, or protein energy wasting (PEW), syndrome. Reduced muscle mass seems to be the most solid criterion for the presence of cachexia/PEW in patients with chronic kidney disease (CKD), and those with greater muscle mass loss have a higher risk of death. Children with CKD have many risk factors for lean mass and muscle wasting, including poor appetite, inflammation, growth hormone resistance, and metabolic acidosis. Mortality risks in patients with CKD increases as body mass index (BMI) and weight decreases. However, data regarding cachexia/PEW and muscle wasting in children with CKD is scarce due to lack of consensus in diagnostic criteria and an appropriate investigative methodology. Further research is urgently needed to address this important complication in the pediatric CKD setting, which may have fundamental impact on clinical outcomes.
瘦体重的丢失是恶病质或蛋白质能量消耗（PEW）综合征的一个相关组成部分。肌肉质量的减少似乎是慢性肾脏病（CKD）患者存在恶病质/PEW 的最可靠标准，肌肉质量丢失更多的患者死亡风险更高。CKD 患儿存在许多瘦体重和肌肉消耗的风险因素，包括食欲不佳、炎症、生长激素抵抗和代谢性酸中毒。随着身体质量指数（BMI）和体重下降，CKD 患者的死亡风险增加。然而，由于缺乏诊断标准和适当的研究方法的共识，有关 CKD 患儿恶病质/PEW 和肌肉消耗的数据很少。迫切需要进一步的研究来解决儿科 CKD 环境中的这一重要并发症，这可能对临床结果产生重大影响。
