Nutritional Strategies to Prevent Muscle Loss and Sarcopenia in Chronic Kidney Disease: What Do We Currently Know?
Loss of muscle mass is an extremely frequent complication in patients with chronic kidney disease (CKD). The etiology of muscle loss in CKD is multifactorial and may depend on kidney disease itself, dialysis, the typical chronic low-grade inflammation present in patients with chronic kidney disease,...
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| Veröffentlicht in: | Nutrients 2023-07, Vol.15 (14), p.3107 |
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| description | Loss of muscle mass is an extremely frequent complication in patients with chronic kidney disease (CKD). The etiology of muscle loss in CKD is multifactorial and may depend on kidney disease itself, dialysis, the typical chronic low-grade inflammation present in patients with chronic kidney disease, but also metabolic acidosis, insulin resistance, vitamin D deficiency, hormonal imbalances, amino acid loss during dialysis, and reduced dietary intake. All these conditions together increase protein degradation, decrease protein synthesis, and lead to negative protein balance. Aging further exacerbates sarcopenia in CKD patients. Nutritional therapy, such as protein restriction, aims to manage uremic toxins and slow down the progression of CKD. Low-protein diets (LPDs) and very low-protein diets (VLPDs) supplemented with amino acids or ketoacids are commonly prescribed. Energy intake is crucial, with a higher intake associated with maintaining a neutral or positive nitrogen balance. Adequate nutritional and dietary support are fundamental in preventing nutritional inadequacies and, consequently, muscle wasting, which can occur in CKD patients. This review explores the causes of muscle loss in CKD and how it can be influenced by nutritional strategies aimed at improving muscle mass and muscle strength. |
| doi_str_mv | 10.3390/nu15143107 |
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The etiology of muscle loss in CKD is multifactorial and may depend on kidney disease itself, dialysis, the typical chronic low-grade inflammation present in patients with chronic kidney disease, but also metabolic acidosis, insulin resistance, vitamin D deficiency, hormonal imbalances, amino acid loss during dialysis, and reduced dietary intake. All these conditions together increase protein degradation, decrease protein synthesis, and lead to negative protein balance. Aging further exacerbates sarcopenia in CKD patients. Nutritional therapy, such as protein restriction, aims to manage uremic toxins and slow down the progression of CKD. Low-protein diets (LPDs) and very low-protein diets (VLPDs) supplemented with amino acids or ketoacids are commonly prescribed. Energy intake is crucial, with a higher intake associated with maintaining a neutral or positive nitrogen balance. Adequate nutritional and dietary support are fundamental in preventing nutritional inadequacies and, consequently, muscle wasting, which can occur in CKD patients. This review explores the causes of muscle loss in CKD and how it can be influenced by nutritional strategies aimed at improving muscle mass and muscle strength.</description><identifier>ISSN: 2072-6643</identifier><identifier>EISSN: 2072-6643</identifier><identifier>DOI: 10.3390/nu15143107</identifier><identifier>PMID: 37513525</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Acidosis ; Aging ; Alfacalcidol ; Amino Acids ; Body composition ; Body fat ; Calcifediol ; Chronic kidney failure ; Cytokines ; Development and progression ; Diet ; Diet therapy ; Diet, Protein-Restricted ; Energy ; Frailty ; Hemodialysis ; Humans ; Inflammation ; Insulin resistance ; Kidney diseases ; Malnutrition ; Metabolism ; Metabolites ; Muscles - metabolism ; Musculoskeletal system ; Nitrogen ; Older people ; Phosphorylation ; Protein biosynthesis ; Protein synthesis ; Proteins ; Proteolysis ; Renal Dialysis ; Renal Insufficiency, Chronic - complications ; Renal Insufficiency, Chronic - metabolism ; Renal Insufficiency, Chronic - therapy ; Review ; Sarcopenia ; Sarcopenia - complications ; Sarcopenia - prevention & control ; Vitamin D ; Vitamin deficiency</subject><ispartof>Nutrients, 2023-07, Vol.15 (14), p.3107</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 by the authors. 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-604ae49bca91fe94577ad6aedc726fd51dd7ca5ff96f0ef5cc1430b02c56f4e33</citedby><cites>FETCH-LOGICAL-c474t-604ae49bca91fe94577ad6aedc726fd51dd7ca5ff96f0ef5cc1430b02c56f4e33</cites><orcidid>0000-0002-1040-4952 ; 0000-0001-5766-1297 ; 0000-0001-6196-5656</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10384728/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10384728/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37513525$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Massini, Giulia</creatorcontrib><creatorcontrib>Caldiroli, Lara</creatorcontrib><creatorcontrib>Molinari, Paolo</creatorcontrib><creatorcontrib>Carminati, Francesca Maria Ida</creatorcontrib><creatorcontrib>Castellano, Giuseppe</creatorcontrib><creatorcontrib>Vettoretti, Simone</creatorcontrib><title>Nutritional Strategies to Prevent Muscle Loss and Sarcopenia in Chronic Kidney Disease: What Do We Currently Know?</title><title>Nutrients</title><addtitle>Nutrients</addtitle><description>Loss of muscle mass is an extremely frequent complication in patients with chronic kidney disease (CKD). 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Adequate nutritional and dietary support are fundamental in preventing nutritional inadequacies and, consequently, muscle wasting, which can occur in CKD patients. This review explores the causes of muscle loss in CKD and how it can be influenced by nutritional strategies aimed at improving muscle mass and muscle strength.</description><subject>Acidosis</subject><subject>Aging</subject><subject>Alfacalcidol</subject><subject>Amino Acids</subject><subject>Body composition</subject><subject>Body fat</subject><subject>Calcifediol</subject><subject>Chronic kidney failure</subject><subject>Cytokines</subject><subject>Development and progression</subject><subject>Diet</subject><subject>Diet therapy</subject><subject>Diet, Protein-Restricted</subject><subject>Energy</subject><subject>Frailty</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Insulin resistance</subject><subject>Kidney diseases</subject><subject>Malnutrition</subject><subject>Metabolism</subject><subject>Metabolites</subject><subject>Muscles - metabolism</subject><subject>Musculoskeletal system</subject><subject>Nitrogen</subject><subject>Older people</subject><subject>Phosphorylation</subject><subject>Protein biosynthesis</subject><subject>Protein synthesis</subject><subject>Proteins</subject><subject>Proteolysis</subject><subject>Renal Dialysis</subject><subject>Renal Insufficiency, Chronic - complications</subject><subject>Renal Insufficiency, Chronic - metabolism</subject><subject>Renal Insufficiency, Chronic - therapy</subject><subject>Review</subject><subject>Sarcopenia</subject><subject>Sarcopenia - complications</subject><subject>Sarcopenia - prevention & control</subject><subject>Vitamin D</subject><subject>Vitamin deficiency</subject><issn>2072-6643</issn><issn>2072-6643</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNptkl1vFCEYhSdGY5vaG3-AIfHGmGzlcxi8aZqtVtP1I6mml4RlXnZpZmELTM3--7K21q0RLiDwnAMc3qZ5SfARYwq_CyMRhDOC5ZNmn2JJJ23L2dOd-V5zmPMV3jaJZcueN3tMCsIEFftN-jqW5IuPwQzooiRTYOEhoxLR9wQ3EAr6MmY7AJrFnJEJPbowycY1BG-QD2i6TDF4i859H2CDTn0Gk-E9ulyagk4jugQ0HVOqRsMGnYf46_hF88yZIcPh_XjQ_Pz44cf002T27ezz9GQ2sVzyMmkxN8DV3BpFHCgupDR9a6C3krauF6TvpTXCOdU6DE5YW2PAc0ytaB0Hxg6a4zvf9ThfVVm9QjKDXie_Mmmjo_H68U7wS72IN5pg1nFJu-rw5t4hxesRctErny0MgwkQx6xpxzlWNVJV0df_oFdxTDXU3xTDqmN0h1qYAbQPLtaD7dZUn0ihSKcYo5U6-g9Vew8rb2MA5-v6I8HbO4FN9ZMSuIdHEqy3VaL_VkmFX-3G8oD-qQl2C_YIty0</recordid><startdate>20230711</startdate><enddate>20230711</enddate><creator>Massini, Giulia</creator><creator>Caldiroli, Lara</creator><creator>Molinari, Paolo</creator><creator>Carminati, Francesca Maria Ida</creator><creator>Castellano, Giuseppe</creator><creator>Vettoretti, Simone</creator><general>MDPI AG</general><general>MDPI</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1040-4952</orcidid><orcidid>https://orcid.org/0000-0001-5766-1297</orcidid><orcidid>https://orcid.org/0000-0001-6196-5656</orcidid></search><sort><creationdate>20230711</creationdate><title>Nutritional Strategies to Prevent Muscle Loss and Sarcopenia in Chronic Kidney Disease: What Do We Currently Know?</title><author>Massini, Giulia ; 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The etiology of muscle loss in CKD is multifactorial and may depend on kidney disease itself, dialysis, the typical chronic low-grade inflammation present in patients with chronic kidney disease, but also metabolic acidosis, insulin resistance, vitamin D deficiency, hormonal imbalances, amino acid loss during dialysis, and reduced dietary intake. All these conditions together increase protein degradation, decrease protein synthesis, and lead to negative protein balance. Aging further exacerbates sarcopenia in CKD patients. Nutritional therapy, such as protein restriction, aims to manage uremic toxins and slow down the progression of CKD. Low-protein diets (LPDs) and very low-protein diets (VLPDs) supplemented with amino acids or ketoacids are commonly prescribed. Energy intake is crucial, with a higher intake associated with maintaining a neutral or positive nitrogen balance. 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| subjects | Acidosis Aging Alfacalcidol Amino Acids Body composition Body fat Calcifediol Chronic kidney failure Cytokines Development and progression Diet Diet therapy Diet, Protein-Restricted Energy Frailty Hemodialysis Humans Inflammation Insulin resistance Kidney diseases Malnutrition Metabolism Metabolites Muscles - metabolism Musculoskeletal system Nitrogen Older people Phosphorylation Protein biosynthesis Protein synthesis Proteins Proteolysis Renal Dialysis Renal Insufficiency, Chronic - complications Renal Insufficiency, Chronic - metabolism Renal Insufficiency, Chronic - therapy Review Sarcopenia Sarcopenia - complications Sarcopenia - prevention & control Vitamin D Vitamin deficiency |
| title | Nutritional Strategies to Prevent Muscle Loss and Sarcopenia in Chronic Kidney Disease: What Do We Currently Know? |
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