Abstract
OVERVIEW: As kidney disease advances and the glomerular filtration rate declines, fluid, electrolyte, and hormonal imbalances increase. Almost all of the body's systems are adversely affected. This article describes three major complications of chronic kidney disease: renal osteodystrophy (including the role of secondary hyperparathyroidism), nutritional disturbances (such as protein-energy malnutrition), and inflammation. It also addresses the possibility that there is a malnutrition-inflammation complex syndrome, as well as the impact of kidney disease and its complications on the quality of patients' lives and the usefulness of the Kidney Disease Quality of Life assessment tool.