The impact of chronic kidney disease on muscle tissue metabolism in patients undergoing hemodialysis

Abstract

Objective: to estimate the prevalence of sarcopenia and evaluate the contribution of myostatin and mTOR to the development of muscle mass loss and strength in patients with end-stage renal disease treated with program hemodialysis. Materials and methods: the study included 80 patients with CKD5D, the average age of study participants was 51.7±11.6 years. In all patients, anamnestic data were analyzed, the results of laboratory and instrumental examination were evaluated, the levels of myostatin and mTOR in the blood serum were determined, hand dynamometry, bioimpedancemetry, and a leg raising test were performed. Results: the average volume of muscle mass in the subgroup with sarcopenia was 20.5±0.7 kg and significantly differed from that in the subgroup without sarcopenia 25.23±0.8 kg (p <0.05). The prevalence of sarcopenia in the general group was 38.75%. In men, decreased muscle mass was statistically significantly more common than among women (p <0.05). The level of mTOR in the blood serum of patients with sarcopenia was significantly lower than that in the subgroup without sarcopenia (6.61±0.4 ng/ml and 9.4±0.3 ng/ml, respectively (p <0.001)). The level of myostatin was significantly higher in the subgroup of patients with sarcopenia than without it (12.2±0.6 ng/ml vs. 8.1±0.3 ng/ml, respectively (p <0.001)). The increase in myostatin was accompanied by a decrease in mTOR both in the general group (r=-0.57) and in the subgroup of patients with sarcopenia (r=-0.55). Conclusion: A high prevalence of sarcopenia was found in patients with CKD receiving renal replacement therapy. Myostatin and mTOR have demonstrated their diagnostic potential and can be used as promising markers for the verification of sarcopenia.