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Nutrition clinique et métabolisme
Volume 18, n° 1
pages 3-6 (mars 2004)
Doi : 10.1016/j.nupar.2004.01.009
Received : 23 December 2003 ; 
Altérations métaboliques au cours de l'insuffisance rénale chronique

Fitsum  Guebre-Egziabher b * ,  Denis  Fouque ab
aJE dénutrition des maladies chroniques, université Claude-Bernard Lyon-I, France 
bDépartement de néphrologie et centre de nutrition humaine de Lyon, hôpital Édouard-Herriot, Lyon, France 

*Auteur correspondant. Pavillon P, hôpital É.-Herriot, place d'Arsonval, 69437 Lyon cedex 03, France.
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L'insuffisance rénale chronique entraîne des altérations métaboliques et des dysfonctions nutritionnelles et hormonales nombreuses. À terme, ces altérations sont à l'origine de complications telles que l'anémie, l'ostéodystrophie rénale, l'insulinorésistance, la dyslipidémie et la dénutrition. De plus, l'accumulation de cytokines pro-inflammatoires, le stress oxydant accru et les infections répétées participent à la persistance d'un état inflammatoire chronique. Il existe une corrélation étroite entre la dénutrition et l'inflammation et ces deux anomalies contribuent largement à une survie réduite de ces patients lorsqu'ils sont traités par dialyse chronique. Il est donc essentiel de détecter de façon précoce les anomalies métaboliques et de les traiter avant même le stade de dialyse pour diminuer la morbi-mortalité essentiellement cardiovasculaire.

Mots clés  : Insuffisance rénale chronique ; Anémie ; Dénutrition ; Inflammation.

Abstract

Chronic renal failure results in metabolic derangements, nutritional and hormonal dysfunction which in turn may lead to several complications such as anemia, bone disease, insulin resistance, dyslipidemia and malnutrition. Furthermore, the increased oxidative stress and the accumulation of pro-inflammatory cytokines in addition to repeated infections lead to a persistent inflammatory state. There is a close association between malnutrition and inflammation, and both of which are strong predictors of poor outcome among predialysis and dialysis patients. It is essential to assess early these metabolic disturbances and treat them before the initiation of dialysis in order to prevent the increased cardio-vascular morbi-mortality and malnutrition in chronic renal failure patients.

Mots clés  : Chonic renal failure ; Anemia ; Malnutrition ; Inflammation.




© 2003  Elsevier SAS. All Rights Reserved.

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