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Kim HJ, Seong EY, Jung HJ, Song SH. The phase angle before transplantation can predict the status of low muscle mass after kidney transplantation. Clin Exp Nephrol 2024:10.1007/s10157-024-02543-1. [PMID: 39168881 DOI: 10.1007/s10157-024-02543-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 07/25/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND This study aimed to evaluate the association between phase angle, muscle strength, and muscle mass in patients undergoing kidney transplantation. METHODS Patients whose pre- and follow-up phase angles were measured after kidney transplantation were enrolled. Phase angle and body composition were measured using a multi-frequency bioimpedance analysis device before and at 7 and 14 days and 3, 6, and 12 months after transplantation. Muscle strength was evaluated using handgrip strength (HGS). Low HGS was defined as < 28 kg in males and < 18 kg in females. Low muscle mass was defined as an appendicular lean mass index of < 7.0 kg/m2 in males and < 5.7 kg/m2 in females. RESULTS Eighty-eight patients (mean age 52.3 ± 10.1 years) were analyzed. The mean phase angle of pre-transplantation was 5.0 ± 1.0°. Body fat percentage was significantly higher at 6 and 12 months after transplantation than pre-transplantation (P < 0.0001). Twelve months after kidney transplantation, the prevalence of low HGS decreased (pre-transplantation vs. 12 months post-transplantation: 28.4% vs. 17.0%), and the prevalence of low muscle mass (pre-transplantation vs. 12 months post-transplantation: 21.6% vs. 28.4%) increased. The pre-transplantation phase angle was significantly associated with low muscle mass at 12 months after kidney transplantation (odds ratio [OR]: 0.34; 95% confidence interval [CI]: 0.16-0.72; P = 0.005). The pre-transplantation phase angle was not significantly associated with low HGS (OR: 0.37; 95% CI 0.12-1.17; P = 0.090) 12 months after kidney transplantation. CONCLUSIONS Pre-transplantation phase angle can predict muscle mass status 12 months after kidney transplantation.
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Affiliation(s)
- Hyo Jin Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, South Korea
- Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
- Organ Transplantation Center, Pusan National University Hospital, Busan, South Korea
| | - Eun Young Seong
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, South Korea
- Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
- Organ Transplantation Center, Pusan National University Hospital, Busan, South Korea
| | - Hyuk Jae Jung
- Organ Transplantation Center, Pusan National University Hospital, Busan, South Korea
- Department of Surgery, Pusan National University School of Medicine, Yangsan, South Korea
- Department of Surgery and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Sang Heon Song
- Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, South Korea.
- Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
- Organ Transplantation Center, Pusan National University Hospital, Busan, South Korea.
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Abrahim S, Steele AP, Voth J, Krepinsky JC, Lanktree MB, Hawke TJ. Whole body resistance training on functional outcomes of patients with Stage 4 or 5 chronic kidney disease: A systematic review. Physiol Rep 2024; 12:e16151. [PMID: 39134506 PMCID: PMC11319065 DOI: 10.14814/phy2.16151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 07/03/2024] [Accepted: 07/06/2024] [Indexed: 08/16/2024] Open
Abstract
Chronic kidney disease (CKD) causes skeletal muscle wasting, resulting in reduced function and inability to live independently. This systematic review critically appraised the scientific literature regarding the effects of full-body resistance training on clinically-relevant functional capacity measures in CKD. The study population included studies of people with Stage 4 or 5 CKD and a mean age of 40+ years old. Eight databases were searched for eligible studies: Pubmed, Embase, Cochrane, CINAHL, Scopus, Web of Science, MEDLINE, and AGELINE. MeSH terms and keyword combinations were used for screening following the PRISMA conduct. Inclusion criteria were based on PICO principles and no date of publication filter was applied. The intervention was training 2 days/week of structured resistance exercises using major upper and lower muscle groups. Minimum intervention period was 7 weeks. Comparison groups maintained their habitual activity without structured exercise training. Outcome measures of interest were: 6-min walk test, grip strength, timed up-and-go test, and sit-to-stand. Eight randomized controlled trials and one nonequivalent comparison-group study fulfilled the inclusion criteria and underwent data extraction. All studies were of hemodialysis patients. The evidence indicates that full-body resistance exercise significantly improved grip strength, timed up and go and sit to stand tests; metrics associated with enhanced quality and quantity of life.
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Affiliation(s)
- Salma Abrahim
- Department of Pathology and Molecular MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Alexandra P. Steele
- Department of Pathology and Molecular MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Jennifer Voth
- Research and Evaluation Services Department, Hôtel‐Dieu Grace HealthcareWindsorOntarioCanada
| | - Joan C. Krepinsky
- Division of Nephrology, St. Joseph Healthcare Hamilton and Department of MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Matthew B. Lanktree
- Division of Nephrology, St. Joseph Healthcare Hamilton and Department of MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Thomas J. Hawke
- Department of Pathology and Molecular MedicineMcMaster UniversityHamiltonOntarioCanada
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3
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Romejko K, Szamotulska K, Rymarz A, Tomasz R, Niemczyk S. The association of appendicular skeletal muscle mass with anthropometric, body composition, nutritional, inflammatory, and metabolic variables in non-dialysis-dependent chronic kidney disease men. Front Med (Lausanne) 2024; 11:1380026. [PMID: 39118666 PMCID: PMC11306063 DOI: 10.3389/fmed.2024.1380026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/10/2024] [Indexed: 08/10/2024] Open
Abstract
Background Muscle atrophy affects more than 50% of patients with chronic kidney disease (CKD) and is associated with increased morbidity and mortality. It is crucial to understand the mechanisms involved in the muscle atrophy in CKD and search for specific determinants of skeletal muscle mass loss, especially those which are available in everyday medical practice. This study aimed to evaluate the association between appendicular skeletal muscle mass (ASM) and anthropometric, body composition, nutritional, inflammatory, metabolic, and kidney function variables in non-dialysis-dependent CKD men. Methods A total of 85 men with CKD and eGFR lower than 60 mL/min/1.73 m2 were included in the cross-sectional study: 24 participants with eGFR 59-45 mL/min/1.73 m2, 32 individuals with eGFR 44-30 mL/min/1.73 m2, and 29 men with eGFR ≤29 mL/min/1.73 m2. ASM was estimated by bioimpedance spectroscopy (BIS) with the use of a Body Composition Monitor (BCM). To evaluate ASM from BCM, Lin's algorithm was used. Among anthropometric parameters, height, weight, and body mass index (BMI) were measured. Serum laboratory measurements were grouped into kidney function, nutritional, inflammatory, and metabolic parameters. Results ASM was significantly associated with anthropometric and body composition variables. According to the anthropometric parameters, ASM correlated positively with weight, height, and BMI (p < 0.001 and r = 0.913, p < 0.001 and r = 0.560, and p < 0.001 and r = 0.737, respectively). Among body composition variables, ASM correlated significantly and positively with lean tissue mass (LTM) (p < 0.001, r = 0.746), lean tissue index (LTI) (p < 0.001, r = 0.609), fat mass (p < 0.001, r = 0.489), and fat tissue index (FTI) (p < 0.001, r = 0.358). No other statistically significant correlation was found between ASM and kidney, nutritional, metabolic, and inflammatory variables. Conclusion In male patients with CKD stages G3-G5 not treated with dialysis, ASM correlates significantly and positively with anthropometric and body composition parameters such as weight, height, BMI, LTM, LTI, fat mass, and FTI. We did not observe such relationship between ASM and kidney function, nutritional, metabolic, and inflammatory variables.
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Affiliation(s)
- Katarzyna Romejko
- Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine—National Research Institute, Warsaw, Poland
| | - Katarzyna Szamotulska
- Department of Epidemiology and Biostatistics, Institute of Mother and Child, Warsaw, Poland
| | - Aleksandra Rymarz
- Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine—National Research Institute, Warsaw, Poland
| | - Rozmyslowicz Tomasz
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Stanisław Niemczyk
- Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine—National Research Institute, Warsaw, Poland
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Khalil M, Di Ciaula A, Jaber N, Grandolfo R, Fiermonte F, Portincasa P. Multidimensional Assessment of Sarcopenia and Sarcopenic Obesity in Geriatric Patients: Creatinine/Cystatin C Ratio Performs Better than Sarcopenia Index. Metabolites 2024; 14:306. [PMID: 38921440 PMCID: PMC11205317 DOI: 10.3390/metabo14060306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/17/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
The serum creatinine/cystatin C ratio (CCR) and the sarcopenia index (SI) are novel indicators for sarcopenia, but their accuracy may depend on various confounders. To assess CCR and SI diagnostic accuracy, we studied the clinical and biophysical parameters associated with sarcopenia or sarcopenic obesity. A total of 79 elderly patients (65-99 yrs, 33 females) underwent clinical, anthropometric, body composition, geriatric performance, and blood chemistry evaluation. The CCR and SI accuracy were assessed to identify sarcopenia. Sarcopenia was confirmed in 40.5%, and sarcopenic obesity in 8.9% of the subjects. Sarcopenic patients showed an increased Charlson comorbidity index, cardiovascular disease (CVD) rates and frailty, and decreased physical performance than non-sarcopenic subjects. Patients with sarcopenic obesity had increased body fat and inflammatory markers compared to obese subjects without sarcopenia. Sarcopenia was associated with a decreased CCR and SI. However, when the logistic regression models were adjusted for possible confounders (i.e., age, gender, Charlson comorbidity index, presence of CVD, and frailty score), a significant OR was confirmed for the CCR (OR 0.021, 95% CI 0.00055-0.83) but not for the SI. The AUC for the CCR for sarcopenia discrimination was 0.72. A higher performance was observed in patients without chronic kidney diseases (CKD, AUC 0.83). CCR, more than the SI, is a useful, non-invasive, and cost-effective tool to predict sarcopenia, irrespective of the potential confounders, particularly in subjects without CKD.
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Affiliation(s)
| | | | | | | | | | - Piero Portincasa
- Clinica Medica “A. Murri”, Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (M.K.); (A.D.C.); (N.J.); (R.G.); (F.F.)
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5
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Lair B, Lac M, Frassin L, Brunet M, Buléon M, Feuillet G, Maslo C, Marquès M, Monbrun L, Bourlier V, Montastier E, Viguerie N, Tavernier G, Laurens C, Moro C. Common mouse models of chronic kidney disease are not associated with cachexia. Commun Biol 2024; 7:346. [PMID: 38509307 PMCID: PMC10954638 DOI: 10.1038/s42003-024-06021-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 03/07/2024] [Indexed: 03/22/2024] Open
Abstract
The 5/6 nephrectomy and adenine-induced nephropathy mouse models have been extensively used to study Chronic Kidney Disease (CKD)-related cachexia. One common caveat of these CKD models is the cross-sectional nature of comparisons made versus controls. We here performed a comprehensive longitudinal assessment of body composition and energy metabolism in both models. The most striking finding is that weight loss is largely driven by reduced food intake which promotes rapid loss of lean and fat mass. However, in both models, mice catch up weight and lean mass a few days after the surgery or when they are switched back to standard chow diet. Muscle force and mass are fully recovered and no sign of cachexia is observed. Our data demonstrate that the time-course of kidney failure and weight loss are unrelated in these common CKD models. These data highlight the need to reconsider the relative contribution of direct and indirect mechanisms to muscle wasting observed in CKD.
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Affiliation(s)
- Benjamin Lair
- Team MetaDiab, Institute of Metabolic and Cardiovascular Diseases, INSERM/Paul Sabatier University UMR1297, Toulouse, France
| | - Marlène Lac
- Team MetaDiab, Institute of Metabolic and Cardiovascular Diseases, INSERM/Paul Sabatier University UMR1297, Toulouse, France
| | - Lucas Frassin
- Team MetaDiab, Institute of Metabolic and Cardiovascular Diseases, INSERM/Paul Sabatier University UMR1297, Toulouse, France
| | - Manon Brunet
- Team Renal Fibrosis and Chronic Kidney Diseases, Institute of Metabolic and Cardiovascular Diseases, INSERM/Paul Sabatier University UMR1297, Toulouse, France
| | - Marie Buléon
- Team Renal Fibrosis and Chronic Kidney Diseases, Institute of Metabolic and Cardiovascular Diseases, INSERM/Paul Sabatier University UMR1297, Toulouse, France
| | - Guylène Feuillet
- Team Renal Fibrosis and Chronic Kidney Diseases, Institute of Metabolic and Cardiovascular Diseases, INSERM/Paul Sabatier University UMR1297, Toulouse, France
| | - Claire Maslo
- Team MetaDiab, Institute of Metabolic and Cardiovascular Diseases, INSERM/Paul Sabatier University UMR1297, Toulouse, France
| | - Marie Marquès
- Team MetaDiab, Institute of Metabolic and Cardiovascular Diseases, INSERM/Paul Sabatier University UMR1297, Toulouse, France
| | - Laurent Monbrun
- Team MetaDiab, Institute of Metabolic and Cardiovascular Diseases, INSERM/Paul Sabatier University UMR1297, Toulouse, France
| | - Virginie Bourlier
- Team MetaDiab, Institute of Metabolic and Cardiovascular Diseases, INSERM/Paul Sabatier University UMR1297, Toulouse, France
| | - Emilie Montastier
- Team MetaDiab, Institute of Metabolic and Cardiovascular Diseases, INSERM/Paul Sabatier University UMR1297, Toulouse, France
| | - Nathalie Viguerie
- Team MetaDiab, Institute of Metabolic and Cardiovascular Diseases, INSERM/Paul Sabatier University UMR1297, Toulouse, France
| | - Geneviève Tavernier
- Team MetaDiab, Institute of Metabolic and Cardiovascular Diseases, INSERM/Paul Sabatier University UMR1297, Toulouse, France
| | - Claire Laurens
- Team MetaDiab, Institute of Metabolic and Cardiovascular Diseases, INSERM/Paul Sabatier University UMR1297, Toulouse, France
| | - Cedric Moro
- Team MetaDiab, Institute of Metabolic and Cardiovascular Diseases, INSERM/Paul Sabatier University UMR1297, Toulouse, France.
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Fang YW, Wang C, Lin CY. Association between urinary glyphosate levels and hand grip strength in a representative sample of US adults: NHANES 2013-2014. Front Public Health 2024; 12:1352570. [PMID: 38450138 PMCID: PMC10915012 DOI: 10.3389/fpubh.2024.1352570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/01/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Glyphosate, a widely utilized herbicide globally, has been linked to various health issues, including cancer, birth abnormalities, and reproductive issues. Additionally, there is growing experimental support indicating potential harm to skeletal muscles. Despite this, the impact of glyphosate on human muscle health remains unclear. Methods We examined information gathered from the 2013-2014 National Health and Nutrition Examination Survey (NHANES), which included 1466 adults aged 18 or older. Our primary aim was to investigate the relationship between glyphosate exposure and hand grip strength, as well as its influence on lean muscle mass. Results and discussion Our investigation uncovered a detrimental correlation between glyphosate exposure and all measures of grip strength, except for the second test of the first hand. Specifically, we observed a statistically significant adverse association between glyphosate exposure and combined grip strength, which is calculated as the sum of the highest readings from both hands (ß coefficient of -2.000, S.E. = 0.891, p = 0.040). We did not observe a significant correlation between glyphosate levels, lean muscle mass, and the likelihood of reaching maximum grip strength meeting sarcopenia criteria. Additionally, we observed an interaction between age and glyphosate, as well as between body mass index (BMI) and glyphosate, concerning the association with combined grip strength. In this comprehensive analysis of NHANES data, our study reveals a potential association between glyphosate exposure and hand grip strength in the adult population. Our findings suggest the need for deeper exploration into the health effects of glyphosate exposure and its impact on muscle strength, shedding light on possible public health concerns.
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Affiliation(s)
- Yu-Wei Fang
- Division of Nephrology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
| | - ChiKang Wang
- Department of Environmental Engineering and Health, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Chien-Yu Lin
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
- Department of Environmental Engineering and Health, Yuanpei University of Medical Technology, Hsinchu, Taiwan
- Department of Internal Medicine, En Chu Kong Hospital, New Taipei City, Taiwan
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Elia R, Piva G, Bulighin F, Lamberti N, Manfredini F, Gambaro G, Di Maria A, Salvagno G, Carbonare LGD, Storari A, Valenti MT, Battaglia Y. The Impact of Physical Exercise on microRNAs in Hemodialysis Patients: A Review and a Protocol for an Ancillary Study. Biomedicines 2024; 12:468. [PMID: 38398071 PMCID: PMC10886953 DOI: 10.3390/biomedicines12020468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/12/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
Physical inactivity is considered a significant risk factor for mortality and morbidity among chronic hemodialysis (HD) patients. Therefore, physical exercise is recommended in the treatment of HD patients. Although the beneficial effects of physical exercise in HD patients are well-described in the literature, the underlying physiological mechanisms still need to be fully understood. Recently, microRNAs (miRNAs) have emerged as potential mediators of the therapeutic effects of physical exercise in healthy individuals. miRNAs are short, single-stranded, noncoding RNAs involved in gene expression regulation. Specifically, upon forming the RNA-induced silencing complex, miRNAs selectively bind to specific miRNAs within cells, reducing gene expression. miRNAs can be secreted by cells in an accessible form or enclosed within exosomes or extracellular vesicles. They can be detected in various body fluids, including serum (circulating miRNAs), facilitating the study of their diverse expression. Currently, there is no available data regarding the impact of physical exercise on the expression of miRNAs involved in osteogenic differentiation, a fundamental mechanism in the development of vascular calcification, for HD patients. Therefore, we have designed an observational and longitudinal case-control study to evaluate the expression of miR-9 and miR-30b in HD patients participating in a 3-month interdialytic physical exercise program. This paper aims to present the study protocol and review the expression of circulating miRNAs in HD patients and their modulation through physical exercise.
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Affiliation(s)
- Rossella Elia
- PhD Program in Clinical and Experimental Biomedical Sciences, Department of Medicine, University of Verona, 37129 Verona, Italy;
| | - Giovanni Piva
- PhD Program in Environmental Sustainability and Wellbeing, Department of Humanities, University of Ferrara, 44122 Ferrara, Italy;
| | - Francesca Bulighin
- Nephrology and Dialysis Unit, Pederzoli Hospital, 37019 Peschiera del Garda, Italy;
- Department of Medicine, University of Verona, 37129 Verona, Italy
| | - Nicola Lamberti
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44122 Ferrara, Italy; (N.L.); (F.M.)
| | - Fabio Manfredini
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44122 Ferrara, Italy; (N.L.); (F.M.)
| | - Giovanni Gambaro
- Nephrology and Dialysis Unit, Department of Medicine, University of Verona, 37129 Verona, Italy;
| | - Alessio Di Maria
- Nephrology and Dialysis Unit, University Hospital of Ferrara, 44122 Ferrara, Italy; (A.D.M.); (A.S.)
| | - Gianluca Salvagno
- Section of Clinical Biochemistry, University of Verona, 37129 Verona, Italy;
| | - Luca Giuseppe Dalle Carbonare
- Internal Medicine, Section D, Department of Medicine, University of Verona, 37129 Verona, Italy; (L.G.D.C.); (M.T.V.)
| | - Alda Storari
- Nephrology and Dialysis Unit, University Hospital of Ferrara, 44122 Ferrara, Italy; (A.D.M.); (A.S.)
| | - Maria Teresa Valenti
- Internal Medicine, Section D, Department of Medicine, University of Verona, 37129 Verona, Italy; (L.G.D.C.); (M.T.V.)
| | - Yuri Battaglia
- Nephrology and Dialysis Unit, Pederzoli Hospital, 37019 Peschiera del Garda, Italy;
- Department of Medicine, University of Verona, 37129 Verona, Italy
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8
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Musolino M, Presta P, Cianfrone P, Errante MA, Andreucci M, Coppolino G, Bolignano D. Self-Reported Physical Inactivity and Mood Disturbances in End-Stage Kidney Disease (ESKD) Patients on Chronic Dialysis Treatment. J Clin Med 2023; 12:7160. [PMID: 38002771 PMCID: PMC10672008 DOI: 10.3390/jcm12227160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Physical inactivity and mood disturbances are key issues in individuals with end-stage kidney disease (ESKD) and may lead to poor clinical outcomes. METHODS We performed a pilot, observational study to explore the possible relationships between the self-reported level of physical activity (IPAQ) and the severity of mood disturbances (BDI score) in a cohort of 58 ESKD patients undergoing chronic hemodialysis (HD; n = 30) or peritoneal dialysis (PD; n = 28). RESULTS Overall, ESKD patients were severely inactive (median METs: 590 [460-1850]) and the intensity of overall and walking physical activity was mostly low to moderate. HD individuals appeared less active than PD (METs 550 [250-1600] vs. 1080 [750-1730]; p = 0.003) and were also less prone to walking (METs 180 ± 90 vs. 320 ± 100; p = 0.01), while a barely statistical difference was noticed for the time spent sitting. ESKD individuals displayed a median BDI score of 17 [12-21], which indicated, on average, the presence of borderline depression, which was apparently more evident among HD individuals. A strong, inverse correlation was found between self-reported METs and BDI scores (R = -0.78; p < 0.0001), while such scores paralleled the time spent sitting during a weekday (R = 0.45; p = 0.0004) and a weekend day (R = 0.40; p = 0.002). CONCLUSIONS In ESKD patients on chronic dialysis, physical inactivity and mood disturbances might be significantly inter-connected, thereby amplifying their relative impact on quality of life, dysautonomia and long-term outcomes. Future studies on larger populations are recommended to confirm these preliminary observations. Promoting strategies to improve fitness, along with greater attention to physiological aspects, should be incorporated into the clinical management of ESKD patients.
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Affiliation(s)
- Michela Musolino
- Nephrology and Dialysis Unit, University “Magna-Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Pierangela Presta
- Nephrology and Dialysis Unit, University “Magna-Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | - Paola Cianfrone
- Nephrology and Dialysis Unit, University “Magna-Graecia” of Catanzaro, 88100 Catanzaro, Italy
| | | | - Michele Andreucci
- Nephrology and Dialysis Unit, University “Magna-Graecia” of Catanzaro, 88100 Catanzaro, Italy
- Department of Health Sciences, University “Magna-Graecia” of Catanzaro, Viale Europa SNC, 88100 Catanzaro, Italy
| | - Giuseppe Coppolino
- Nephrology and Dialysis Unit, University “Magna-Graecia” of Catanzaro, 88100 Catanzaro, Italy
- Department of Health Sciences, University “Magna-Graecia” of Catanzaro, Viale Europa SNC, 88100 Catanzaro, Italy
| | - Davide Bolignano
- Nephrology and Dialysis Unit, University “Magna-Graecia” of Catanzaro, 88100 Catanzaro, Italy
- Department of Medical and Surgical Sciences, University “Magna-Graecia” of Catanzaro, Viale Europa SNC, 88100 Catanzaro, Italy
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9
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Lonardo MS, Cacciapuoti N, Chiurazzi M, Di Lauro M, Guida B, Damiano S, Cataldi M. Combined use of handgrip strength and hemoglobin as markers of undernutrition in patients with stage 3-5 chronic kidney disease. Nutr Metab Cardiovasc Dis 2023; 33:2169-2178. [PMID: 37544868 DOI: 10.1016/j.numecd.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 05/31/2023] [Accepted: 06/19/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND AND AIMS The early identification of undernourished patients with CKD could help instating appropriate nutritional intervention before the full development of the threatening condition known as Protein Energy Wasting (PEW). Handgrip strength (HGS) and blood hemoglobin (Hb) concentration are two parameters considered representative of nutritional status but not included among the criteria for PEW diagnosis. In the present work we investigated whether they could help identifying CKD patients at risk of undernutrition. METHODS AND RESULTS We performed a two-step cluster analysis to classify a cohort of 71 stage 3-5 CKD patients, none of which with PEW, according to their Hb concentration and dominant-hand HGS. Two clusters were finely separated using this method. When we compared the two groups for main body composition and nutritional variables by using t-test statistics or Mann-Whitney test, as appropriate, we found significant differences in PhA, ECW/TBW, ASMI, serum iron. Then we stratified our population by gender and performed cluster analysis as well. PhA, ECW/TBW were still significantly different in the two clusters both in M and in F, while serum iron concentration only in males and ASMI only in females. CONCLUSION These results suggest that either in male than in female Hb concentration and HGS may distinguish two subgroups of CKD patients with different nutritional status and disease severity. Patient belonging to either of these cluster can be easily identified by using the HGS/Hb ratio which represents the HGS normalized per gr Hb.
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Affiliation(s)
- Maria Serena Lonardo
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy.
| | - Nunzia Cacciapuoti
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy
| | - Martina Chiurazzi
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy
| | - Mariastella Di Lauro
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy
| | - Bruna Guida
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy
| | - Simona Damiano
- Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Italy
| | - Mauro Cataldi
- Department of Neuroscience, Reproductive Sciences and Dentistry, Division of Pharmacology, Federico II University of Naples, Italy
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10
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Ju SH, Yi HS. Clinical features and molecular mechanism of muscle wasting in end stage renal disease. BMB Rep 2023; 56:426-438. [PMID: 37482754 PMCID: PMC10471459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 07/25/2023] Open
Abstract
Muscle wasting in end-stage renal disease (ESRD) is an escalating issue due to the increasing global prevalence of ESRD and its significant clinical impact, including a close association with elevated mortality risk. The phenomenon of muscle wasting in ESRD, which exceeds the rate of muscle loss observed in the normal aging process, arises from multifactorial processes. This review paper aims to provide a comprehensive understanding of muscle wasting in ESRD, covering its epidemiology, underlying molecular mechanisms, and current and emerging therapeutic interventions. It delves into the assessment techniques for muscle mass and function, before exploring the intricate metabolic and molecular pathways that lead to muscle atrophy in ESRD patients. We further discuss various strategies to mitigate muscle wasting, including nutritional, pharmacological, exercise, and physical modalities intervention. This review seeks to provide a solid foundation for future research in this area, fostering a deeper understanding of muscle wasting in ESRD, and paving the way for the development of novel strategies to improve patient outcomes. [BMB Reports 2023; 56(8): 426-438].
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Affiliation(s)
- Sang Hyeon Ju
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon 35015, Korea
| | - Hyon-Seung Yi
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon 35015, Korea
- Laboratory of Endocrinology and Immune System, Chungnam National University School of Medicine, Daejeon 35015, Korea
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Barbalho SM, Minniti G, Miola VFB, Haber JFDS, Bueno PCDS, de Argollo Haber LS, Girio RSJ, Detregiachi CRP, Dall'Antonia CT, Rodrigues VD, Nicolau CCT, Catharin VMCS, Araújo AC, Laurindo LF. Organokines in COVID-19: A Systematic Review. Cells 2023; 12:1349. [PMID: 37408184 DOI: 10.3390/cells12101349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/03/2023] [Accepted: 05/06/2023] [Indexed: 07/07/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a viral infection caused by SARS-CoV-2 that induces a generalized inflammatory state. Organokines (adipokines, osteokines, myokines, hepatokines, and cardiokines) can produce beneficial or harmful effects in this condition. This study aimed to systematically review the role of organokines on COVID-19. PubMed, Embase, Google Scholar, and Cochrane databases were searched, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and 37 studies were selected, comprising more than 2700 individuals infected with the virus. Among COVID-19 patients, organokines have been associated with endothelial dysfunction and multiple organ failure due to augmented cytokines and increased SARS-CoV-2 viremia. Changes in the pattern of organokines secretion can directly or indirectly contribute to aggravating the infection, promoting immune response alterations, and predicting the disease progression. These molecules have the potential to be used as adjuvant biomarkers to predict the severity of the illness and severe outcomes.
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Affiliation(s)
- Sandra Maria Barbalho
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Department of Biochemistry and Nutrition, School of Food and Technology of Marília (FATEC), Avenida Castro Alves, 62, Marília 17500-000, SP, Brazil
| | - Giulia Minniti
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Vitor Fernando Bordin Miola
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Jesselina Francisco Dos Santos Haber
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Centro Interdisciplinar em Diabetes (CENID), School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Patrícia Cincotto Dos Santos Bueno
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Department of Animal Sciences, School of Veterinary Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Luiza Santos de Argollo Haber
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Raul S J Girio
- Department of Animal Sciences, School of Veterinary Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Cláudia Rucco Penteado Detregiachi
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Department of Biochemistry and Pharmacology, Faculdade de Medicina de Marília (FAMEMA), School of Medicine, Avenida Monte Carmelo, 800, Marília 17519-030, SP, Brazil
| | - Camila Tiveron Dall'Antonia
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Victória Dogani Rodrigues
- Department of Biochemistry and Pharmacology, Faculdade de Medicina de Marília (FAMEMA), School of Medicine, Avenida Monte Carmelo, 800, Marília 17519-030, SP, Brazil
| | - Claudia C T Nicolau
- Department of Biochemistry and Nutrition, School of Food and Technology of Marília (FATEC), Avenida Castro Alves, 62, Marília 17500-000, SP, Brazil
| | - Virginia Maria Cavallari Strozze Catharin
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Adriano Cressoni Araújo
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
| | - Lucas Fornari Laurindo
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Avenida Hygino Muzzy Filho, 1001, Marília 17525-902, SP, Brazil
- Department of Biochemistry and Pharmacology, Faculdade de Medicina de Marília (FAMEMA), School of Medicine, Avenida Monte Carmelo, 800, Marília 17519-030, SP, Brazil
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Barone R, Szychlinska MA. Highlights in Pathophysiology of the Musculoskeletal System. Int J Mol Sci 2023; 24:ijms24076412. [PMID: 37047383 PMCID: PMC10094568 DOI: 10.3390/ijms24076412] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023] Open
Abstract
The intention of the present Special Issue is to focus on the latest research in the musculoskeletal system, with an emphasis on the molecular mechanisms underlying its pathophysiology, as well as innovative diagnostic tools and therapeutic perspectives [...]
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Nagarajan Bhuvaneswari V, Alexander H, Shenoy MT, D S, Kanakasekaran S, Pradipta Kumar M, Murugiah V. Comparison of Serum Urea, Salivary Urea, and Creatinine Levels in Pre-Dialysis and Post-Dialysis Patients: A Case-Control Study. Cureus 2023; 15:e36685. [PMID: 37113359 PMCID: PMC10127148 DOI: 10.7759/cureus.36685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2023] [Indexed: 03/29/2023] Open
Abstract
Background Frequent venepuncture for monitoring of serum urea and creatinine in chronic kidney disease (CKD) patients on dialysis will result in venous damage and infection. In this research, we assessed the feasibility of utilizing salivary samples as a substitute for serum samples in determining the levels of urea and creatinine in patients with CKD undergoing dialysis. Methods The study participants included 50 patients diagnosed with CKD undergoing hemodialysis and an equal number of apparently healthy individuals. We measured the serum and salivary levels of urea and creatinine in normal subjects. CKD patients were also subjected to similar investigations both before and after hemodialysis. Results In our study, we found that the mean value of salivary urea and creatinine are significantly elevated in the case group (salivary urea: 99.56 ± 43.28 mg/dL, salivary creatinine: 1.10 ± 0.83 mg/dL) as compared to the control group (salivary urea: 33.62 ± 23.84 mg/dL, salivary creatinine: 0.15±0.12 mg/dL, p value: <0.001). There was a statistically significant reduction in the mean value of salivary urea and creatinine in the post-dialysis sample (salivary urea: 45.06 ± 30.37 mg/dL, salivary creatinine: 0.43±0.44 mg/dL) compared to the pre-dialysis sample (salivary urea: 99.56 ± 43.28 mg/dL, salivary creatinine: 1.10 ± 0.83 mg/dL; p value: <0.001) in the case group. The salivary urea is significantly positively correlated with serum urea (r value: 0.366, p value: 0.009). But there is no significant correlation seen between salivary and serum creatinine. We have created a cut-off for salivary urea (52.5 mg/dL) to diagnose CKD which has a good sensitivity (84%) and specificity (78%). Conclusion The results of our study suggest that the estimation of salivary urea and creatinine could serve as a non-invasive, alternative marker for the diagnosis of CKD, and benefit in risk-free monitoring of their progress before and after hemodialysis.
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Wang K, Liu Q, Tang M, Qi G, Qiu C, Huang Y, Yu W, Wang W, Sun H, Ni X, Shen Y, Fang X. Chronic kidney disease-induced muscle atrophy: Molecular mechanisms and promising therapies. Biochem Pharmacol 2023; 208:115407. [PMID: 36596414 DOI: 10.1016/j.bcp.2022.115407] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/28/2022] [Accepted: 12/28/2022] [Indexed: 01/02/2023]
Abstract
Chronic kidney disease (CKD) is a high-risk chronic catabolic disease due to its high morbidity and mortality. CKD is accompanied by many complications, leading to a poor quality of life, and serious complications may even threaten the life of CKD patients. Muscle atrophy is a common complication of CKD. Muscle atrophy and sarcopenia in CKD patients have complex pathways that are related to multiple mechanisms and related factors. This review not only discusses the mechanisms by which inflammation, oxidative stress, mitochondrial dysfunction promote CKD-induced muscle atrophy but also explores other CKD-related complications, such as metabolic acidosis, vitamin D deficiency, anorexia, and excess angiotensin II, as well as other related factors that play a role in CKD muscle atrophy, such as insulin resistance, hormones, hemodialysis, uremic toxins, intestinal flora imbalance, and miRNA. We highlight potential treatments and drugs that can effectively treat CKD-induced muscle atrophy in terms of complication treatment, nutritional supplementation, physical exercise, and drug intervention, thereby helping to improve the prognosis and quality of life of CKD patients.
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Affiliation(s)
- Kexin Wang
- Department of Nephrology, the Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province 226001, PR China; Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Jiangsu Clinical Medicine Center of Tissue Engineering and Nerve Injury Repair, Nantong University, Nantong, Jiangsu Province 226001, PR China
| | - Qingyuan Liu
- Department of Endocrinology, Binhai County People's Hospital, Yancheng, Jiangsu Province 224500, PR China
| | - Mingyu Tang
- Xinglin College, Nantong University, Nantong, Jiangsu Province 226001, PR China
| | - Guangdong Qi
- Department of Endocrinology, Binhai County People's Hospital, Yancheng, Jiangsu Province 224500, PR China
| | - Chong Qiu
- Department of Clinical Medicine, Medical College, Nantong University, Nantong, Jiangsu Province 226001, PR China
| | - Yan Huang
- Department of Clinical Medicine, Medical College, Nantong University, Nantong, Jiangsu Province 226001, PR China
| | - Weiran Yu
- Department of Clinical Medicine, Medical College, Nantong University, Nantong, Jiangsu Province 226001, PR China
| | - Wei Wang
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Jiangsu Clinical Medicine Center of Tissue Engineering and Nerve Injury Repair, Nantong University, Nantong, Jiangsu Province 226001, PR China; Department of Pathology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong 226001, PR China
| | - Hualin Sun
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Jiangsu Clinical Medicine Center of Tissue Engineering and Nerve Injury Repair, Nantong University, Nantong, Jiangsu Province 226001, PR China
| | - Xuejun Ni
- Department of Ultrasound Medicine, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province 226001, PR China.
| | - Yuntian Shen
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-Innovation Center of Neuroregeneration, NMPA Key Laboratory for Research and Evaluation of Tissue Engineering Technology Products, Jiangsu Clinical Medicine Center of Tissue Engineering and Nerve Injury Repair, Nantong University, Nantong, Jiangsu Province 226001, PR China.
| | - Xingxing Fang
- Department of Nephrology, the Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province 226001, PR China.
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Acevedo LM, Vidal Á, Aguilera-Tejero E, Rivero JLL. Muscle plasticity is influenced by renal function and caloric intake through the FGF23-vitamin D axis. Am J Physiol Cell Physiol 2023; 324:C14-C28. [PMID: 36409180 DOI: 10.1152/ajpcell.00306.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Skeletal muscle, the main metabolic engine in the body of vertebrates, is endowed with great plasticity. The association between skeletal muscle plasticity and two highly prevalent health problems: renal dysfunction and obesity, which share etiologic links as well as many comorbidities, is a subject of great relevance. It is important to know how these alterations impact on the structure and function of skeletal muscle because the changes in muscle phenotype have a major influence on the quality of life of the patients. This literature review aims to discuss the influence of a nontraditional axis involving kidney, bone, and muscle on skeletal muscle plasticity. In this axis, the kidneys play a role as the main site for vitamin D activation. Renal disease leads to a direct decrease in 1,25(OH)2-vitamin D, secondary to reduction in renal functional mass, and has an indirect effect, through phosphate retention, that contributes to stimulate fibroblast growth factor 23 (FGF23) secretion by bone cells. FGF23 downregulates the renal synthesis of 1,25(OH)2-vitamin D and upregulates its metabolism. Skeletal production of FGF23 is also regulated by caloric intake: it is increased in obesity and decreased by caloric restriction, and these changes impact on 1,25(OH)2-vitamin D concentrations, which are decreased in obesity and increased after caloric restriction. Thus, both phosphate retention, that develops secondary to renal failure, and caloric intake influence 1,25(OH)2-vitamin D that in turn plays a key role in muscle anabolism.
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Affiliation(s)
- Luz M Acevedo
- Department of Comparative Anatomy and Pathological Anatomy and Toxicology, Faculty of Veterinary Sciences, Laboratory of Muscular Biopathology, University of Cordoba, Spain.,Departamento de Ciencias Biomédicas, Facultad de Ciencias Veterinarias, Universidad Central de Venezuela, Maracay, Venezuela
| | - Ángela Vidal
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Spain
| | - Escolástico Aguilera-Tejero
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Spain
| | - José-Luis L Rivero
- Department of Comparative Anatomy and Pathological Anatomy and Toxicology, Faculty of Veterinary Sciences, Laboratory of Muscular Biopathology, University of Cordoba, Spain
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Nogueira Á, Álvarez G, Barril G. Impact of the Nutrition-Inflammation Status on the Functionality of Patients with Chronic Kidney Disease. Nutrients 2022; 14:nu14224745. [PMID: 36432432 PMCID: PMC9697176 DOI: 10.3390/nu14224745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022] Open
Abstract
Functional capacity of chronic kidney disease (CKD) patients is compromised by their nutrition-inflammation status. We evaluated the functional capacity of advanced chronic kidney disease (ACKD) patients and the influence of the nutrition-inflammation status. In a cross-sectional study, which included ACKD patients from the nephrology department of the Hospital Universitario de la Princesa in Madrid, Spain, we assessed: functional capacity with the Short Physical Performance Battery (SPPB) test, interpreting a result <7 in the test as low functionality; body composition with monofrequency bioimpedance; muscular strength with hand grip strength; nutritional and inflammatory status using biochemical parameters and the Malnutrition Inflammation Scale (MIS). A total of 255 patients with ACKD were evaluated, 65.8% were men, their mean age was 70.65 ± 11.97 years and 70.2% of the patients had an age >65 years. The mean score of SPPB was 8.50 ± 2.81 and 76.4% of the patients presented a score ≥7, with a higher percentage in the group of men. The percentage of patients with limitations increased with age. The patients with SPPB values higher than 7 showed high values of albumin and low soluble C-reactive protein (s-CRP) and MIS. We found better functionality in well-nourished patients. A multivariate logistic regression model established an association of high albumin values with a better functional capacity (OR: 0.245 CI: 0.084−0.714 p < 0.010), while another model showed an association between CRP values and decreased functionality (OR: 1.267 CI: 1.007−1.594 p = 0.044). Conclusion: nutritional status and body composition influence on the functional capacity of patients with ACKD.
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Serrano E, Whitaker-Menezes D, Lin Z, Roche M, Martinez Cantarin MP. Uremic Myopathy and Mitochondrial Dysfunction in Kidney Disease. Int J Mol Sci 2022; 23:ijms232113515. [PMID: 36362298 PMCID: PMC9653774 DOI: 10.3390/ijms232113515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 10/28/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022] Open
Abstract
Alterations in muscle structure and function in chronic kidney disease (CKD) patients are associated with poor outcomes. As key organelles in muscle cell homeostasis, mitochondrial metabolism has been studied in the context of muscle dysfunction in CKD. We conducted a study to determine the contribution of oxidative metabolism, glycolysis and fatty acid oxidation to the muscle metabolism in CKD. Mice developed CKD by exposure to adenine in the diet. Muscle of CKD mice showed significant weight loss compared to non-CKD mice, but only extensor digitorum longus (EDL) muscle showed a decreased number of fibers. There was no difference in the proportion of the various muscle fibers in CKD and non-CKD mice. Muscle of CKD mice had decreased expression of proteins associated with oxidative phosphorylation but increased expression of enzymes and transporters associated with glycolysis. In cell culture, myotubes exposed to uremic serum demonstrated decreased oxygen consumption rates (OCR) when glucose was used as substrate, conserved OCR when fatty acids were used and increased lactate production. In conclusion, mice with adenine-induced CKD developed sarcopenia and with increased glycolytic metabolism but without gross changes in fiber structure. In vitro models of uremic myopathy suggest fatty acid utilization is preserved compared to decreased glucose utilization.
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Affiliation(s)
- Eurico Serrano
- Division of Nephrology, Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, 33 S 9th Street, Suite 700, Philadelphia, PA 19107, USA
| | | | - Zhao Lin
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Megan Roche
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Maria Paula Martinez Cantarin
- Division of Nephrology, Department of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, 33 S 9th Street, Suite 700, Philadelphia, PA 19107, USA
- Correspondence:
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Indoxyl Sulfate Might Play a Role in Sarcopenia, While Myostatin Is an Indicator of Muscle Mass in Patients with Chronic Kidney Disease: Analysis from the RECOVERY Study. Toxins (Basel) 2022; 14:toxins14100660. [PMID: 36287929 PMCID: PMC9610577 DOI: 10.3390/toxins14100660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 11/17/2022] Open
Abstract
Serum myostatin and indoxyl sulfate (IS) levels increase with kidney function decline and may function as uremic toxins in chronic kidney disease (CKD)-related sarcopenia. Herein, we analyzed the association between serum myostatin and IS levels and sarcopenia in patients with CKD, by performing a post hoc analysis of baseline data extracted from the RECOVERY study (clinicaltrials.gov: NCT03788252) of 150 patients with CKD. We stratified patients into two groups according to the median value of myostatin (cutoff 4.5 ng/mL) and IS levels (cutoff 0.365 mg/dL). The proportion of patients with sarcopenia was higher in those with high IS levels but lower in those with high myostatin levels. The skeletal muscle mass index (SMI) and handgrip strength (HGS) were significantly lower in patients with high IS levels but significantly higher in patients with high myostatin levels. IS levels showed a negative correlation with glomerular filtration rate (GFR), SMI, and HGS. However, myostatin levels were positively correlated with SMI and HGS, but not with GFR. Sarcopenia was independently associated with age and IS level after adjustment. Increased levels of serum total IS might play a role in sarcopenia, while increased levels of serum myostatin are associated with muscle mass in patients with CKD.
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