Secondary Hyperparathyroidism and Protein‐Energy Wasting in End‐Stage Renal Disease

Secondary Hyperparathyroidism and Protein‐Energy Wasting in End‐Stage Renal Disease Protein‐energy wasting (PEW), a syndrome involving adverse changes in nutrition and body composition, is a serious problem associated with morbidity and mortality in patients with end‐stage renal disease (ESRD). The pathogenesis of PEW is multifactorial, and the underlying mechanisms are not fully understood. However, recent translational work has provided compelling evidence for a causal role of parathyroid hormone (PTH) in the pathogenesis of adipose tissue browning and increased energy expenditure, a critical component of PEW in ESRD. These results provide a biological explanation for the clinical association between secondary hyperparathyroidism (SHPT) and PEW in hemodialysis patients and may serve as an additional rationale for treating SHPT. Large‐scale clinical and epidemiological studies should determine the clinical significance of SHPT as a contributor to PEW and establish the optimal management of SHPT to ameliorate PEW. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Therapeutic Apheresis and Dialysis Wiley

Secondary Hyperparathyroidism and Protein‐Energy Wasting in End‐Stage Renal Disease

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Publisher
Wiley
Copyright
© 2018 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy
ISSN
1744-9979
eISSN
1744-9987
D.O.I.
10.1111/1744-9987.12683
Publisher site
See Article on Publisher Site

Abstract

Protein‐energy wasting (PEW), a syndrome involving adverse changes in nutrition and body composition, is a serious problem associated with morbidity and mortality in patients with end‐stage renal disease (ESRD). The pathogenesis of PEW is multifactorial, and the underlying mechanisms are not fully understood. However, recent translational work has provided compelling evidence for a causal role of parathyroid hormone (PTH) in the pathogenesis of adipose tissue browning and increased energy expenditure, a critical component of PEW in ESRD. These results provide a biological explanation for the clinical association between secondary hyperparathyroidism (SHPT) and PEW in hemodialysis patients and may serve as an additional rationale for treating SHPT. Large‐scale clinical and epidemiological studies should determine the clinical significance of SHPT as a contributor to PEW and establish the optimal management of SHPT to ameliorate PEW.

Journal

Therapeutic Apheresis and DialysisWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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