Patogénesis de la malnutrición en pacientes en diálisis con énfasis en los aspectos más específicos de la diálisis peritoneal

Protein-energy malnutrition (PEM) is a frequent complication in patients with chronic renal insufficiency (occurring in 30-70% of patients under peritoneal dialysis) and is associated with high morbidity and mortality. Knowledge of the pathogenesis of malnutrition is the key to adopting appropriate prophylactic measures and to providing rational and effective treatment. The present article provides an up-to-date review of basic and pathogenic aspects of PEM, with special emphasis on the specific characteristics of peritoneal dialysis patients. Among the causes susceptible to therapeutic intervention are the various factors contributing to reduced food intake, poor digestion, malabsorption, protein loss, the impact of constant peritoneal glucose absorption as an osmotic agent, and the increase in protein catabolism.