Muscle wasting in end-stage renal disease promulgates premature death: Established, emerging and potential novel treatment strategies

Peter Stenvinkel, Juan Jesus Carrero, Ferdinand Von Walden, T. Alp Ikizler, Gustavo A. Nader

Research output: Contribution to journalReview article

58 Scopus citations

Abstract

Muscle wasting (or sarcopenia) is a common feature of the uremic phenotype and predisposes this vulnerable patient population to increased risk of comorbid complications, poor quality of life, frailty and premature death. The old age of dialysis patients is in addition a likely contributor to loss ofmuscle mass. As recent evidence suggests that assessment of muscle strength (i.e. function) is a better predictor of outcome and comorbidities than muscle mass, this opens new screening, assessment and therapeutic opportunities. Among established treatment strategies, the benefit of resistance exercise and endurance training are increasingly recognized among nephrologists as being effective and should be promoted in sedentary chronic kidney disease patients. Testosterone and growth hormone replacement appear as the most promising among emerging treatments strategies for muscle wasting. As treatment of muscle wasting is difficult and seldom successful in this often old, frail, sedentary and exercisehesitant patient group, novel treatment strategies are urgently needed. In this review, we summarize recent studies on stimulation of mitochondrial biogenesis, myogenic stem (satellite) cells andmanipulation of transforming growth factor familymembers, all of which hold promise for more effective therapies to target muscle mass loss and function in the future.

Original languageEnglish (US)
Pages (from-to)1070-1077
Number of pages8
JournalNephrology Dialysis Transplantation
Volume31
Issue number7
DOIs
StatePublished - Jan 1 2016

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

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