Cachexia

Definition

Cachexia is a complex metabolic syndrome characterized by involuntary loss of more than 5% body weight (in the absence of starvation) with loss of skeletal muscle, anorexia, fatigue, and systemic inflammation. It is not reversible by standard nutrition alone.

Associated Conditions

• Advanced cancer (most common)
• AIDS
• COPD
• Chronic heart failure
• End-stage renal disease
• Rheumatoid arthritis

Clinical Features

Profound weight loss, temporal wasting, sarcopenia, anorexia, fatigue, decreased functional status, and poor prognosis. Low albumin, elevated CRP, and increased resting energy expenditure distinguish cachexia from simple malnutrition.

Nursing Interventions

Offer small, nutrient-dense frequent meals; high-protein, high-calorie oral supplements; appetite stimulants (megestrol, dronabinol); and address underlying disease. Provide emotional support; cachexia is psychologically distressing for patients and families. Palliative focus is often appropriate.

NCLEX Relevance

Recognize cachexia as a hallmark of advanced cancer, AIDS, and COPD, distinguished from simple malnutrition.