Muscle Wasting in Chronic Kidney Disease: Mechanism and Clinical Implications—A Narrative Review
Abstract
:1. Introduction
2. Mechanism Underlying Muscle Wasting in CKD
2.1. Increased Protein Degradation
2.1.1. Activation of the Ub-Proteasome System and Caspase-3
2.1.2. Lysosome-Mediated Autophagy
2.2. Supressed Protein Synthesis
2.3. Impaired Muscle Regeneration
2.4. Alterations in microRNAs Expression
2.5. Gut Microbiota Dysbiosis
3. Therapeutic Strategies for Muscle Wasting
Major Category | Subitem | Reference |
---|---|---|
Nutritional intervention | Dietary modification (Low protein diet or very low protein diet) | [85,86,87] |
Vitamin D supplement | [88] | |
Probiotics/Prebiotics | [34,84] | |
AST-120 | [89,90,91] | |
Pharmacological therapy and potential therapeutic intervention | Myostatin inhibitors * (ActRIIB receptor blockade) | [92,93] |
Interleukin-1 blockade * | [94,95] | |
Ghrelin and leptin regulation * | [96,97] | |
miRNAs * | [72] | |
Activin A blockade * | [98] | |
Exercise | Aerobic and resistance exercises | [99,100,101,102,103,104] |
Physical modalities intervention | Neuromuscular electrical stimulation | [105] |
Extracorporeal shockwave therapy | [106] | |
Photobiomodulation | [107] |
3.1. Nutritional Intervention
3.2. Pharmacological Therapy and Potential Therapeutic Intervention
3.3. Exercise Training
3.4. Physical Modalities Intervention
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Cheng, T.-C.; Huang, S.-H.; Kao, C.-L.; Hsu, P.-C. Muscle Wasting in Chronic Kidney Disease: Mechanism and Clinical Implications—A Narrative Review. Int. J. Mol. Sci. 2022, 23, 6047. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms23116047
Cheng T-C, Huang S-H, Kao C-L, Hsu P-C. Muscle Wasting in Chronic Kidney Disease: Mechanism and Clinical Implications—A Narrative Review. International Journal of Molecular Sciences. 2022; 23(11):6047. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms23116047
Chicago/Turabian StyleCheng, Tsai-Chin, Shou-Hsien Huang, Chung-Lan Kao, and Po-Cheng Hsu. 2022. "Muscle Wasting in Chronic Kidney Disease: Mechanism and Clinical Implications—A Narrative Review" International Journal of Molecular Sciences 23, no. 11: 6047. https://0-doi-org.brum.beds.ac.uk/10.3390/ijms23116047