Skeletal Muscle Complications in Chronic Kidney Disease

Abstract

Purpose of review: To provide an overview of the recent literature investigating the pathophysiology of skeletal muscle changes, interventions for skeletal muscle, and effects of exercise in chronic kidney disease (CKD).

Recent findings: There are multiple CKD-related changes that negatively impact muscle size and function. However, the variability in the assessment of muscle size, in particular, hinders the ability to truly understand the impact it may have in CKD. Exercise interventions to improve muscle size and function demonstrate inconsistent responses that warrant further investigation to optimize exercise prescription. Despite progress in the field, there are many gaps in the knowledge of the pathophysiology of sarcopenia of CKD. Identifying these gaps will help in the design of interventions that can be tested to target muscle loss and its consequences such as impaired mobility, falls, and poor quality of life in patients with CKD.

Keywords: Chronic kidney disease; Inflammation; Klotho; Oxidative stress; Sarcopenia; Skeletal muscle fibrosis; Skeletal muscle regeneration; Uremic toxins.

Fig. 1

Sarcopenia in chronic kidney disease: Mechanisms, assessment, and exercise effects. Some factors included above are beyond the scope of this review but are still important to consider in the context of sarcopenia in chronic kidney disease. Abbreviations: MPS, muscle protein synthesis; DXA, dual-energy X-ray absorptiometry; CT, computerized tomography; MRI, magnetic resonance imaging