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Appetite Stimulants for Treatment of Protein Energy Wasting of Chronic Kidney Disease.

Nutritional and metabolic abnormalities, or protein energy wasting, is a common complication of chronic kidney disease, leading to significant morbidity and mortality. The cause of these abnormalities is multifactorial, and therefore, difficult to treat. The International Society of Renal Nutrition and Metabolism suggests appetite stimulants, including megestrol, dronabinol, mirtazapine, and cyproheptadine, as adjunctive treatment options in addition to parenteral or oral nutritional supplementation. This article reviews the evidence for use of these drugs as appetite stimulants and discusses their use in patients with chronic kidney disease.