Disease Information for Starvation ketosis

exclusive fat burning for energy with dehydration hemoconcentration and regional hypoperfusion and poor renal perfusion contribute--------------------------- Starvation [protein-calorie] History of decreased intake of energy or protein, increased nutrient losses, or increased nutrient requirements; Manifestations range from weight loss and growth failure to distinct syndromes, kwashiorkor, and marasmus; In severe cases, virtually all organ systems are affected; Protein loss correlates with weight loss; Thirty-five to 40% total body weight loss is usually fatal; Protein-energy malnutrition occurs as a result of a relative or absolute deficiency of energy and protein; It may be primary, due to inadequate food intake, or secondary, as a result of other illness; For most developing nations, primary protein-energy malnutrition remains among the most significant health problems; Protein-energy malnutrition has been described as two distinct syndromes: Kwashiorkor, caused by a deficiency of protein in the presence of adequate energy, is typically seen in weaning infants at the birth of a sibling in areas where foods containing protein are insufficiently abundant; Marasmus, caused by combined protein and energy deficiency, is most commonly seen where adequate quantities of food are not available; In industrialized societies, protein-energy malnutrition is most often secondary to other diseases; Kwashiorkor-like secondary protein-energy malnutrition occurs primarily in association with hypermetabolic acute illnesses such as trauma, burns, and sepsis; Marasmus-like secondary protein-energy malnutrition typically results from chronic diseases such as chronic obstructive pulmonary disease (COPD), congestive heart failure, cancer, or AIDS; These syndromes have been estimated to be present in at least 20% of hospitalized patients; A substantially greater number of patients have risk factors that could result in these syndromes; In both syndromes, protein-energy malnutrition is caused either by decreased intake of energy and protein, increased nutrient losses, or increased nutrient requirements dictated by the underlying illness; For example, diminished oral intake may result from poor dentition or various gastrointestinal disorders; Loss of nutrients results from malabsorption and diarrhea as well as from glycosuria; Nutrient requirements are increased by fever, surgery, neoplasia, and burns; Protein-energy malnutrition affects every organ system; The most obvious results are loss of body weight, adipose stores, and skeletal muscle mass; Weight losses of 5–10% are usually tolerated without loss of physiologic function; losses of 35–40% of body weight usually result in death; Loss of protein from skeletal muscle and internal organs is usually proportionate to weight loss; Protein mass is lost from the liver, gastrointestinal tract, kidneys, and heart; As protein-energy malnutrition progresses, organ dysfunction develops: Hepatic synthesis of serum proteins decreases, and depressed levels of circulating proteins are observed; Cardiac output and contractility are decreased, and the ECG may show decreased voltage and a rightward axis shift;

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