Pharmacological intervention for sarcopenia in chronic kidney disease

Abstract

Sarcopenia, the age-related loss of skeletal muscle mass, is characterized by a deterioration of muscle quantity and quality, leading to a gradual slowing of movement, a decline in strength and power, increased risk of fall-related injury, and often frailty. Chronic kidney disease (CKD) is characterized by the gradual loss of renal function over a period of months to years. CKD is a catabolic state, leading to renal sarcopenia. This chapter focuses on the recent advances of pharmacological approaches for attenuating normal and CKD-induced sarcopenia. A myostatin-inhibiting antibody is the most important candidate to prevent normal sarcopenia in humans, but is needed for time to determine the effect for CKD-induced sarcopenia. Although treatment with ghrelin seems to be applicable for both types of sarcopenia in humans, further validation of this trial is necessary by increasing the sample size, varying the range of doses during treatment, and observing other outcomes. Supplementation with ursolic acid is also an intriguing candidate to combat normal and CKD-induced sarcopenia, although further systematic and fundamental research is needed for this treatment on humans.