Is Loss Of Appetite An Indication Of Early Signs Of Kidney Disease? Expert Shares Underlying Causes

Decreased appetite, also known as poor appetite or loss of appetite, refers to a reduced desire to eat. The medical term for this is anorexia. Various mental and physical health issues can lead to decreased appetite, which may be accompanied by symptoms like weight loss or malnutrition. If not treated, these symptoms can pose serious health risks. Therefore, it's important to identify the underlying cause of decreased appetite and address it promptly.

Dr Manoharan B, Senior Consultant – Nephrology, Manipal Hospital Varthur Road & Whitefield, Bengaluru shares how a decreased appetite can be indictive of early signs of kidney damage and diseases.

Symptoms of Decreased Appetite

Several conditions can cause decreased appetite. Typically, once the underlying condition is treated, appetite tends to return to normal. However, if left untreated, decreased appetite can lead to more severe symptoms given by Dr Manoharan:

- extreme fatigue

- weight loss

- a rapid heart rate

- fever

- irritability

- a general ill feeling, or malaise

Decreased Appetite in Chronic Kidney Disease

"Persistent decreased appetite can lead to malnutrition or deficiencies in essential vitamins and electrolytes, which may result in life-threatening complications. Therefore, it is crucial to seek medical attention if you experience a decreased appetite that persists beyond the duration of an acute illness or lasts longer than a few weeks", says Dr Manoharan.

"The gradual decrease in glomerular filtration rate among individuals with chronic kidney disease is often accompanied by a notable decline in food intake. Around one third of chronic dialysis patients report experiencing a fair or poor appetite, directly impacting patient outcomes in a negative manner. Appetite regulation involves the gastrointestinal tract hormones such as ghrelin, cholecystokinin, and the brain, which integrates the stimuli in the hypothalamus area", he adds further.

Causes of Anorexia in Chronic Kidney Disease

Dr Manoharan highlights, "In non-dialyzed chronic kidney disease patients and those undergoing maintenance dialysis, anorexia is primarily linked to the buildup of unidentified anorexigenic compounds and inflammatory cytokines. Additionally, alterations in appetite regulation, such as amino acid imbalances, contribute to increased transport of free tryptophan across the blood-brain barrier. This results in a hyper serotoninergic state, which is conducive to reduced appetite. Increased PTH levels in patients with CKD are also associated with poor appetite."

Treatment for Anorexia in Chronic Kidney Disease

"Treatment for anorexia usually involves counseling, beginning dialysis treatments for uremic chronic kidney disease patients, optimizing the dialysis dose, and potentially introducing appetite stimulants."

"In patients with ESRD on dialysis, there are protein catabolic processes, such as the unavoidable loss of amino acids (6–8 g per HD session) and albumin into the dialysate. IV amino acid supplements such as pure crystalline amino acid solutions are highly beneficial without discomfort for HD patients", concludes Dr Manoharan.