Protein-Energy Wasting (PEW)
ISRNM-defined syndrome of body store loss in chronic kidney disease characterized by serum chemistry abnormalities (low albumin, prealbumin), low body mass, reduced muscle mass, and reduced intake.
Also: PEW
PEW affects 28-54% of dialysis patients and predicts mortality. Pathophysiology includes anorexia from uremia, metabolic acidosis-induced muscle proteolysis, dialysis-related amino acid losses, chronic inflammation, and insulin resistance. Management combines optimized dialysis, alkali therapy, intradialytic parenteral nutrition for severe cases, oral nutritional supplements, and exercise.
How one textbook covers it
Modern Nutrition in Health and Disease, 12th ed. — Ch 96: Nutrition, Diet, and the Kidney
PEW affects 28-54% of dialysis patients and predicts mortality. Pathophysiology includes anorexia from uremia, metabolic acidosis-induced muscle proteolysis, dialysis-related amino acid losses, chronic inflammation, and insulin resistance. Management combines optimized dialysis, alkali therapy, intradialytic parenteral nutrition for severe cases, oral nutritional supplements, and exercise.
Related terms
CKD, Cachexia, GLIM criteria