Clinical relevance of sarcopenia in chronic kidney disease

Ranjani N. Moorthi, Keith G. Avin

Research output: Contribution to journalReview article

35 Scopus citations

Abstract

Purpose of review In this article, we review sarcopenia in chronic kidney disease (CKD). We aim to present how definitions of sarcopenia from the general population may pertain to those with CKD, its assessment by clinicians and emerging therapies for sarcopenia in CKD. For this review, we limit our description and recommendations to patients with CKD who are not on dialysis. Recent findings Poorer parameters of lean mass, strength and physical function are associated with worsening patientcentered outcomes such as limiting mobility, falls and mortality in CKD; however, the magnitude of these associations are different in those with and without CKD. Sarcopenia in CKD is a balance between skeletal muscle regeneration and catabolism, which are both altered in the uremic environment. Multiple pathways are involved in these derangements, which are briefly reviewed. Differences between commonly used terms cachexia, frailty, protein-energy wasting, dynapenia and sarcopenia are described. Therapeutic options in predialysis CKD are not well studied; therefore, we review exercise options and emerging pharmacological therapies. Summary Sarcopenia, now with its own International Classification of Diseases, 10th Revision (ICD-10) code, is of importance clinically and should be accounted for in research studies in patients with CKD. Multiple therapies for sarcopenia are in development and will hopefully be available for our patients in the future.

Original languageEnglish (US)
Pages (from-to)219-228
Number of pages10
JournalCurrent Opinion in Nephrology and Hypertension
Volume26
Issue number3
DOIs
StatePublished - May 1 2017

Keywords

  • Cachexia
  • muscle atrophy
  • muscle weakness
  • physical performance measures
  • protein-energy wasting

ASJC Scopus subject areas

  • Internal Medicine
  • Nephrology

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