Are there two types of malnutrition in chronic renal failure? Evidence for relationships between malnutrition, inflammation and atherosclerosis (MIA syndrome)

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Abstract
It is believed that malnutrition is common in patients with chronic renal failure (CRF). They have reduced body weight, depleted energy (fat tissue) stores, loss of somatic protein (low muscle mass) and low levels of serum albumin, transferrin, pre‐albumin and other visceral proteins. Various studies show signs of malnutrition in 23–76% of haemodialysis (HD) and 18–50% of peritoneal dialysis (PD) patients [1–4]. Such variations in the prevalence of malnutrition may be related to factors such as age, case mix, co‐morbid conditions and quality of dialysis therapy. The aetiology of malnutrition in CRF is complex and may include many factors, e.g. poor food intake because of anorexia, nausea and vomiting due to uraemic toxicity, hormonal derangements, acidosis and increased resting energy expenditure.