Sarcopenia in chronic kidney disease: what have we learned so far?
- PDF / 879,152 Bytes
- 26 Pages / 595.276 x 790.866 pts Page_size
- 16 Downloads / 175 Views
REVIEW
Sarcopenia in chronic kidney disease: what have we learned so far? Alice Sabatino1 · Lilian Cuppari2 · Peter Stenvinkel3 · Bengt Lindholm3 · Carla Maria Avesani3,4 Received: 2 April 2020 / Accepted: 12 August 2020 © The Author(s) 2020
Abstract The term sarcopenia was first introduced in 1988 by Irwin Rosenberg to define a condition of muscle loss that occurs in the elderly. Since then, a broader definition comprising not only loss of muscle mass, but also loss of muscle strength and low physical performance due to ageing or other conditions, was developed and published in consensus papers from geriatric societies. Sarcopenia was proposed to be diagnosed based on operational criteria using two components of muscle abnormalities, low muscle mass and low muscle function. This brought awareness of an important nutritional derangement with adverse outcomes for the overall health. In parallel, many studies in patients with chronic kidney disease (CKD) have shown that sarcopenia is a prevalent condition, mainly among patients with end stage kidney disease (ESKD) on hemodialysis (HD). In CKD, sarcopenia is not necessarily age-related as it occurs as a result of the accelerated protein catabolism from the disease and from the dialysis procedure per se combined with low energy and protein intakes. Observational studies showed that sarcopenia and especially low muscle strength is associated with worse clinical outcomes, including worse quality of life (QoL) and higher hospitalization and mortality rates. This review aims to discuss the differences in conceptual definition of sarcopenia in the elderly and in CKD, as well as to describe etiology of sarcopenia, prevalence, outcome, and interventions that attempted to reverse the loss of muscle mass, strength and mobility in CKD and ESKD patients. Keywords Sarcopenia · Chronic kidney disease · End stage kidney disease · Skeletal muscle mass · Muscle strength · Physical performance
Introduction Loss of muscle mass is a prevalent complication in patients with chronic kidney disease (CKD) and especially in those with end stage kidney disease (ESKD) [1–3]. The causes are diverse and ultimately converge to increased protein degradation and reduced protein synthesis, resulting in a state of negative protein balance [4]. This condition eventually leads to a nutritional disturbance known as protein energy wasting * Carla Maria Avesani [email protected] 1
Division of Nephrology, Department of Medicine and Surgery, University of Parma, Parma, Italy
2
Division of Nephrology, Federal University of São Paulo and Oswaldo Ramos Foundation, São Paulo, Brazil
3
Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Technology and Intervention, Karolinska Institute, Stockholm, Sweden
4
Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil
(PEW) that for long has been mostly attributed to malnutrition [5]. In addition to PEW/malnutrition, the terms sarcopenia and cachexia denote nutritional derangements that are
Data Loading...
