Sarcopenia in CKD: The effect of CKD on muscle mass

Chronic kidney disease (CKD) is associated with skeletal muscle wasting due to imbalance between muscle protein synthesis and catabolism. Physiologic dysfunction and structure abnormalities of muscle such as atrophy reduce strength or reduce endurance leading to decline in physical activity, increased burden of falls, fractures, immobility and loss of functional independence termed as "sarcopenia" and is associated with increased risk of morbidity and mortality. Several mechanism could cause loss of muscle in patients with CKD such as inflammation, metabolic acidosis, malnutrition, defective insulin signaling, activation of the ubiquitin-proteasome system (UPS), vitamin D deficiency and physical inactivity. In this review, we describe the clinical relevance of sarcopenia in CKD how CKD influences muscle metabolism and the clinical implication of sarkopenia in patients with CKD.