Clinical relevance of sarcopenia in chronic kidney disease.
Clinical relevance of sarcopenia in chronic kidney disease.
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DOI：
10.1097/mnh.0000000000000318
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发表时间：
2017-05
影响因子：
3.2
通讯作者：
Avin KG
中科院分区：
文献类型：
--
作者：
Moorthi RN;Avin KG
在这篇文章中，我们审查肌肉减少症在慢性肾脏病（CKD）。我们的目的是介绍普通人群中肌肉减少症的定义如何与CKD患者相关，临床医生对CKD肌肉减少症的评估以及CKD肌肉减少症的新兴疗法。在本综述中，我们将我们的描述和建议限于未接受透析的CKD患者。瘦体重、力量和身体功能的可能参数与CKD患者以患者为中心的结局恶化相关，如活动受限、福尔斯和死亡率;然而，这些相关性的程度在有和无CKD的患者中不同。CKD中的肌肉减少症是骨骼肌再生和catalysis之间的平衡，这两者在尿毒症环境中都发生了改变。多个途径参与这些紊乱，这是简要回顾。描述了恶病质、虚弱、蛋白质-能量消耗、肌营养不良和肌肉减少症之间常用术语的差异。透析前CKD的治疗选择尚未得到充分研究，因此，我们回顾了运动选择和新兴的药物治疗。肌肉减少症，现在有自己的国际疾病分类，第10版（ICD-10）代码，在临床上很重要，应该在CKD患者的研究中考虑。用于肌肉减少症的多种疗法正在开发中，并有望在未来为我们的患者提供。
In this article, we review sarcopenia in chronic kidney disease (CKD). We aim to present how definitions of sarcopenia from the general population may pertain to those with CKD, its assessment by clinicians and emerging therapies for sarcopenia in CKD. For this review, we limit our description and recommendations to patients with CKD who are not on dialysis. Poorer parameters of lean mass, strength and physical function are associated with worsening patient-centered outcomes such as limiting mobility, falls and mortality in CKD; however, the magnitude of these associations are different in those with and without CKD. Sarcopenia in CKD is a balance between skeletal muscle regeneration and catabolism, which are both altered in the uremic environment. Multiple pathways are involved in these derangements, which are briefly reviewed. Differences between commonly used terms cachexia, frailty, protein-energy wasting, dynapenia and sarcopenia are described. Therapeutic options in predialysis CKD are not well studied; therefore, we review exercise options and emerging pharmacological therapies. Sarcopenia, now with its own International Classification of Diseases, 10th Revision (ICD-10) code, is of importance clinically and should be accounted for in research studies in patients with CKD. Multiple therapies for sarcopenia are in development and will hopefully be available for our patients in the future.