Muscle-bone axis in children with chronic kidney disease: current knowledge and future perspectives

Karava, Vasiliki; Dotis, John; Christoforidis, Athanasios; Kondou, Antonia; Printza, Nikoleta

doi:10.1007/s00467-021-04936-w

Cited by 14 publications

(19 citation statements)

References 159 publications

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“…Frailty syndrome is commonly observed in adult CKD patients, with an incidence exceeding 40% in CKD 5D [ 22 ]. Interestingly, this condition has been recently reported in the pediatric CKD population, with a higher frequency in advanced stages, and has been associated with a higher hospitalization rate and lower bone mineral density [ 23 , 24 ]. Therefore, although the literature data are limited, the need arises for the systematic recording of fatigue in CKD pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

“…Similar studies are lacking in the pediatric population. Nevertheless, given that physical fatigue is primarily affected by bone and muscle status, the protection of musculoskeletal health seems crucial for preventing fatigue in this population [ 23 ]. The management of cognitive and sleep/rest fatigue remains a challenge in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

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Fatigue and Quality of Life in Children with Chronic Kidney Disease

et al. 2022

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Background: This study investigates the effect of chronic kidney disease (CKD) stage on fatigue and health-related quality of life (HRQoL) in the pediatric population. Material and Methods: The PedsQL (Pediatric Quality of Life Inventory) Multidimensional Fatigue Scale (subcategories: general, sleep/rest, and cognitive fatigue) and HRQoL Generic Core Scales (subcategories: physical, emotional, social, and school functioning) questionnaires were completed by 30 patients aged from 7 to 18 years old with CKD stage 2–4, CKD stage 5 on dialysis (CKD 5D), and kidney transplantation (KTx), as well as their parents. Results: Both low “Total Fatigue” and “Total HRQoL” scores were reported in 16.7% of patients. “Sleep/Rest Fatigue”, “Emotional Functioning”, and “School functioning” were the lowest scored subcategories. CKD 5D/KTx patients presented lower “Sleep/Rest Fatigue” (p = 0.022) and, more frequently, low “School Functioning” scores (p = 0.029). The “Total HRQoL” score was correlated to the “Total Fatigue” score (rs = 0.625, p < 0.001). A low “Sleep/Rest Fatigue” score was associated with low “Physical Functioning”, “School Functioning”, and “Total HRQoL” scores (p = 0.016, p = 0.001, and p = 0.047 respectively). Parents’ HRQoL score was lower than patients’ score on “Physical Functioning” (p = 0.040) and “School Functioning” subcategories (p = 0.045). Conclusions: Fatigue and disturbed HRQoL are mostly observed in CKD 5D and KTx pediatric patients, and are associated with sleep disorders and school dysfunction. Fatigue affects HRQoL, which is perceived as more deteriorated by the patients’ parents.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fatigue and Quality of Life in Children with Chronic Kidney Disease

et al. 2022

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“…Moreover, the authors observed a negative association between alfacalcidol index, defined in their study as weekly alfacalcidol dose per PTH level, and muscle wasting in advanced CKD, suggesting that alfacalcidol index may also serve as a marker of nutritional status. Insights from these data regarding the contributive effect of high PTH on muscle wasting and the protective role of active vitamin D supplementation on muscle preservation suggest further studies are needed, to explore the pathogenic mechanisms linking muscle status and mineral balance in CKD with subsequent clinical outcomes (6).…”

Section: Mineral and Bone Disorder In Ckdmentioning

confidence: 99%

Editorial: Mineral and Bone Disorder in CKD

et al. 2022

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“…Skeletal muscle and bone are tightly connected anatomically and physiologically and play a crucial role in locomotion and metabolism. Additionally, adipose tissue is vital in this biochemical crosstalk [ 1 , 2 , 3 ]. These three organs share a common mesenchymal precursor and communicate through the endocrine system, secreting a family of cytokines, namely myokines (from muscle), adipokines (from adipocytes) and bone markers (from bone cells) [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Relationships between Body Weight Status and Serum Levels of Adipokine, Myokine and Bone Metabolism Parameters in Healthy Normal Weight and Thin Children

Ambroszkiewicz¹,

Chełchowska²,

Mazur

et al. 2022

JCM

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Optimal body weight and body composition for age are relevant to child development and healthy life. Changes in lean mass and fat mass as well as its distribution are associated with alterations in the secretion of myokines and adipokines by muscle and adipose tissues. These factors are very important for bone health. The aim of the study was to assess serum leptin, adiponectin, resistin, visfatin and omentin as adipokines and myostatin and irisin as myokines with regard to their associations with bone parameters in healthy normal weight and thin children. We studied 81 healthy prepubertal children (aged 5 to 9 years) divided into three groups: group A—35 children with a BMI z-score between +1 and −1 SD; group B—36 children with a BMI z-score between −1 and −2 SD; and group C—10 thin children with a BMI z-score of <−2 SD. We observed significantly (p < 0.001) lower fat mass, fat/lean mass ratio and bone mineral density (BMD) across weight status with the lowest values in the group of thin children. We noticed significantly (p < 0.05) lower concentrations of 25-hydroxyvitamin D, resistin and high-molecular-weight (HMW) adiponectin but higher levels of myostatin as the BMI z-score deceased. We found that BMI and leptin levels were directly correlated with fat mass, lean mass, bone mineral content (BMC) and BMD. Resistin levels were negatively associated with lean mass, while visfatin concentrations were positively related to total BMD. In healthy prepubertal children there were differences in body composition and in bone mineral density across decreasing BMI status. We suggest that changes in serum myostatin and 25-hydroxyvitamin D levels may play a role in bone status of thin children. Moreover, significant relations between adipokines and bone parameters may confirm crosstalk between fat tissue and bone in these children.

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Muscle-bone axis in children with chronic kidney disease: current knowledge and future perspectives

Cited by 14 publications

References 159 publications

Fatigue and Quality of Life in Children with Chronic Kidney Disease

Fatigue and Quality of Life in Children with Chronic Kidney Disease

Editorial: Mineral and Bone Disorder in CKD

Relationships between Body Weight Status and Serum Levels of Adipokine, Myokine and Bone Metabolism Parameters in Healthy Normal Weight and Thin Children

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