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Uremic Sarcopenia.
Subashri Mohanasundaram1, Edwin Fernando1
1Department of Nephrology, Government Stanley Medical College and Hospital, Chennai, Tamil Nadu, India.
Indian Journal of Nephrology
|December 26, 2022
Summary
Uremic sarcopenia, a muscle-wasting condition in chronic kidney disease (CKD), stems from multiple factors and pathways. Exercise and targeted therapies show promise for managing this debilitating condition.
Area of Science:
- Nephrology
- Gerontology
- Muscle Physiology
Background:
- Uremic sarcopenia is characterized by muscle loss in chronic kidney disease (CKD) patients, despite normal muscle physiology.
- It arises from multifactorial causes including immunological, hormonal, and metabolic disturbances, alongside reduced protein intake and physical inactivity.
Purpose of the Study:
- To review recent literature on the abnormalities in skeletal muscle leading to muscle wasting in CKD patients.
- To discuss the complex pathophysiological mechanisms and consequences of uremic sarcopenia.
Main Methods:
- Review of recent publications on skeletal muscle abnormalities in CKD.
- Analysis of pathophysiological pathways and risk factors contributing to muscle wasting.
Main Results:
- Uremic sarcopenia involves complex mechanisms like ubiquitin-proteasome, insulin/IGF-1, myostatin, and indoxyl sulfate pathways, increasing muscle degradation.
- Exercise (aerobic and resistance) demonstrates potential in preventing and mitigating muscle degeneration.
Conclusions:
- Uremic sarcopenia significantly impacts quality of life and increases morbidity and mortality in CKD patients.
- While pharmacological interventions show promise in preclinical studies, human trials are limited, highlighting the need for further research.
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