Abstract

In hemodialysis patients a low body mass index (BMI) is correlated with an unfavorable clinical outcome, a phenomenon known as 'reverse epidemiology'. Mechanisms underlying this observation are unclear. We propose the following: uremic toxin generation occurs predominantly in visceral organs and the mass of key uremiogenic viscera (gut, liver) relative to body weight is higher in small people. Consequently, the rate of uremic toxin generation per unit of BMI is higher in patients with a low BMI. Body water, mainly determined by muscle mass, serves as a dilution compartment for uremic toxins. Therefore, the concentration of uremic toxins is higher in small subjects. Uremic toxins are taken up by adipose and muscle tissues, subsequently metabolized and stored. Thus, the larger the ratio of fat and muscle mass to visceral mass, the lower the concentration of uremic toxins and the better the survival. To test this hypothesis, studies on uremic toxin kinetics in relation to body composition are needed. Copyright © 2007 S. Karger AG, Basel

Diet Tweak System

Diet Tweak System

Trying To Lose Weight Can Be Tough. But... Not Losing Weight and Gaining What You Lost Back, Sucks. If you've ever felt that no matter what you do to lose weight nothing seems to work. If you've ever felt that there has got to be some kind of a system or way to lose weight...but just have not found it yet.

Get My Free Ebook


Post a comment