Anorexia and appetite stimulants in chronic kidney disease

Disease-related malnutrition in chronic kidney disease

“…There are also disturbances in adipocytokines such as leptin and ghrelin which may impact upon hypothalamic regulation of appetite [11]. Uremic toxins are known to play a key role in the induction of anorexia [12]. This impairment of appetite in patients has also been associated with higher mortality [12].…”

“…Furthermore, polypharmacy has also been found to be a significant risk factor [17]. Dialysis is also known to have a catabolic impact by increasing amino acid (AA) losses and has been linked to a reduction in appetite in patients on dialysis days [12].…”

“…Myostatin inhibitors (e.g. antibodies), selective androgen receptor modulators and other drugs such as ghrelin mimetics should be considered for future human clinical trials in CKD [12,42]. Figure 1 highlights some of these potential treatment modalities for disease-related malnutrition in CKD, discussed in this paper.…”

“…Uremic toxins are known to play a key role in the induction of anorexia [12]. This impairment of appetite in patients has also been associated with higher mortality [12]. In particular, inflammation plays a major role in the development of the PEW syndrome [13].…”

“…For example, Deng et al showed that by correcting hypothyroidism in CKD patients there were noticeable significant improvements in albumin, haemoglobin and handgrip strength [41]. Appetite stimulants such as Megestrol Acetate could be a possible treatment as studies have shown use in CKD patients improves appetite, food intake, body weight and serum albumin [12]. Other potential agents which may have anabolic and/or anticatabolic actions in CKD include vitamin D and androgenic anabolic steroids, such as testosterone or nandrolone [42].…”