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Review
. 2021 Aug;34(4):1347-1372.
doi: 10.1007/s40620-020-00840-y. Epub 2020 Sep 2.

Sarcopenia in chronic kidney disease: what have we learned so far?

Alice Sabatino  1 , Lilian Cuppari  2 , Peter Stenvinkel  3 , Bengt Lindholm  3 , Carla Maria Avesani  4   5
Affiliations
Review

Sarcopenia in chronic kidney disease: what have we learned so far?

Alice Sabatino et al. J Nephrol. 2021 Aug.

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: Chronic kidney disease; End stage kidney disease; Muscle strength; Physical performance; Sarcopenia; Skeletal muscle mass.

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Conflict of interest statement

Bengt Lindholm is employed by Baxter Healthcare. Peter Stenvinkel received honoraria for serving at scientific advisory boards at Baxter, Astra Zeneca, REATA, Astellas and FMC. Alice Sabatino received honoraria from Fresenius Kabi for speaking at symposia “International keto-analoghe symposium a Roma” in November 2019. Carla Maria Avesani and Lilian Cuppari have any conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Criteria and clinical outcome of malnutrition/protein energy wasting (PEW), sarcopenia, caquexia and muscle wasting in chronic kidney disease
Fig. 2
Fig. 2
Etiologic factors of muscle derangements leading to muscle loss in chronic kidney disease
See this image and copyright information in PMC

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