Protein & Malnutrition With Lupus Or Raynaud's

Protein and calorie malnutrition often accompany kidney disorders. People afflicted with systemic lupus erythematosus or SLE and Raynaud's phenomenon eventually develop kidney problems. Because energy and nutrient deficiency is common in persons with lupus nephritis, and because malnutrition is a strong predictor of further complications and death, early recognition and aggressive treatment of malnutrition is necessary.

SLE and Raynaud's Disease

Systemic lupus erythematosus is a rare autoimmune rheumatic disorder affecting joints, tendons, connective tissues, kidney, heart and the central nervous system. It is characterized by a Malar or butterfly rash, sunlight sensitivity, arthritis, kidney or renal disorder, blood abnormalities, antinuclear antibodies, mouth ulcers, serositis, neurological and immunological maladies. Serositis is the inflammation of the tissues lining the lungs, heart and abdomen and the organs within them. About half of people with SLE show Raynaud's phenomenon upon diagnosis, but persons afflicted with Raynaud's syndrome will not develop SLE. Raynaud's phenomenon is a condition in which small arteries -- in the fingers and toes -- spasm, causing pale, patchy reddish or bluish skin. SLE is more common in younger Afro-Caribbean and Asian women than Caucasian women and men.

Causes of Malnutrition

Nutrient and energy malnutrition occurs in persons suffering from lupus nephritis in varying degrees whether or not they undergo kidney dialysis - a process of removing toxic waste from the blood when the kidneys are unable to do it. About one-third of patients on maintenance dialysis have mild to moderate protein-energy malnutrition, and approximately 6 to 8 percent have severe malnutrition. Nutrient deficiency can be caused by: lack of appetite; low calorie or protein intake; concurrent chronic disorders; superimposed acute illness or inflammation; wasting effect of dialysis; loss of nutrients -- amino acids, peptides, proteins, glucose, vitamins and minerals -- into dialysate; chronic blood loss; endocrine disorders such as type 2 diabetes; accumulation of by-products that may induce wasting, such as organic and inorganic acids; accumulation of toxic compounds, such as aluminum and loss of metabolic action of the kidney.

Routine Modalities

Customary strategies used in preventing malnutrition includes nutritional counseling, maintaining adequate doses of dialysis, avoiding acidemia -- high levels of acid in the blood; and aggressive treatment of catabolic or wasting illness.

Treatments

Persons with persistent nutritional deficiency may benefit from food supplementation. Food supplements are concentrated sources of nutrients used to augment regular diets. They are marketed as pills, tablets, capsules or liquid in measured amounts. Another means of improving nutritional status is through enteral feeding, whereby a nutritionally balanced liquid is introduced into the stomach through a naso-gastric tube. Total parenteral nutrition presents another alternative. This process involves the administration of a nutrient-rich solution through a large vein.

Experimental Treatments

Lupus patients unable to ingest, absorb or retain nutrients by mouth, tube feeding or intravenous feeding may benefit from intradialytic parenteral nutrition -- a means of providing nutrients intravenously during dialysis. Appetite stimulants such as megestrol acetate, anabolic steroids, recombinant growth hormone and insulin-like growth hormone may be helpful. For your best treatment options, speak with your doctor.