| Theme |
Exercise Therapy and Rehabilitation for Dialysis Patients |
| Title |
Mechanisms of skeletal muscle reduction in patients with chronic kidney disease |
| Author |
Hiromichi Kumagai |
Department of Clinical Nutrition, University of Shizuoka |
| [ Summary ] |
Reduction of skeletal muscle mass is associated with not only patients' activity levels but also longterm prognoses for patients with chronic kidney diseases (CKD). Although skeletal muscle mass is regulated by a balance between muscle synthesis and muscle catabolism, the balance is shifted towards catabolism in CKD. The cellular ubiquitin-proteasome system (UPS) plays an important role in muscle catabolism. The activation of UPS is dependent on cortisol, myostatin and a decrease in insulin and IGF-1. Both inflammation and oxidative stress also stimulate the muscle catabolism. Exercise, correction of metabolic acidosis and testosterone administration may be useful in preventing muscle mass reduction in CKD patients. |