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Review
. 2021 Jan 4;13(1):147.
doi: 10.3390/nu13010147.

Uremic Sarcopenia and Its Possible Nutritional Approach

Annalisa Noce  1 , Giulia Marrone  1   2 , Eleonora Ottaviani  1 , Cristina Guerriero  1 , Francesca Di Daniele  1   2 , Anna Pietroboni Zaitseva  1 , Nicola Di Daniele  1
Affiliations
Review

Uremic Sarcopenia and Its Possible Nutritional Approach

Annalisa Noce et al. Nutrients. .

Abstract

Uremic sarcopenia is a frequent condition present in chronic kidney disease (CKD) patients and is characterized by reduced muscle mass, muscle strength and physical performance. Uremic sarcopenia is related to an increased risk of hospitalization and all-causes mortality. This pathological condition is caused not only by advanced age but also by others factors typical of CKD patients such as metabolic acidosis, hemodialysis therapy, low-grade inflammatory status and inadequate protein-energy intake. Currently, treatments available to ameliorate uremic sarcopenia include nutritional therapy (oral nutritional supplement, inter/intradialytic parenteral nutrition, enteral nutrition, high protein and fiber diet and percutaneous endoscopic gastrectomy) and a personalized program of physical activity. The aim of this review is to analyze the possible benefits induced by nutritional therapy alone or in combination with a personalized program of physical activity, on onset and/or progression of uremic sarcopenia.

Keywords: hemodialysis; intra-dialytic parenteral nutrition; nutritional supplementation; physical activity; uremic sarcopenia; ω-3 polyunsaturated fatty acids.

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Conflict of interest statement

The authors declare no conflict of interests.

Figures

Figure 2
Figure 2
Clinical management of hemodialysis (HD) patients to counteract the onset and the progression of uremic sarcopenia [91]. Abbreviations: b.w., Body weight; DEI, Diet energy intake; DPI, Diet protein intake; EN, Enteral nutritional; GI, Gastrointestinal; IDPN, Intra-parenteral nutrition dialysis; MIS, Malnutrition inflammation score; MM, Muscle mass; PEG, Percutaneous endoscopic gastrectomy; SGA, Subject global assessment; TPN, Total parenteral nutrition.
Figure 1
Figure 1
Possible causes of uremic sarcopenia. AA, amino acids.
See this image and copyright information in PMC

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