title: Chronic kidney disease and premature ageing.
abstract: Chronic kidney disease (CKD) shares many phenotypic similarities with other chronic diseases, including heart failure, chronic obstructive pulmonary disease, HIV infection and rheumatoid arthritis. The most apparent similarity is premature ageing, involving accelerated vascular disease and muscle wasting. We propose that in addition to a sedentary lifestyle and psychosocial and socioeconomic determinants, four major disease-induced mechanisms underlie premature ageing in CKD: an increase in allostatic load, activation of the 'stress resistance response', activation of age-promoting mechanisms and impairment of anti-ageing pathways. The most effective current interventions to modulate premature ageing-treatment of the underlying disease, optimal nutrition, correction of the internal environment and exercise training-reduce systemic inflammation and oxidative stress and induce muscle anabolism. Deeper mechanistic insight into the phenomena of premature ageing as well as early diagnosis of CKD might improve the application and efficacy of these interventions and provide novel leads to combat muscle wasting and vascular impairment in chronic diseases.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastrich, Netherlands.
authors.forename: Jeroen P
authors.initials: JP
authors.lastname: Kooman
authors.affiliation: Renal Research Institute, 315 East 62nd Street, 4th floor, NY 10065, New York, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Kotanko
authors.affiliation: Department of Respiratory Medicine, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastrich, Netherlands.
authors.forename: Annemie M W J
authors.initials: AM
authors.lastname: Schols
authors.affiliation: Institute of Cancer Sciences, Wolfson Wohl Translational Research Centre, University of Glasgow, Garscube Estate, Switchback Road, Bearsden, Glasgow G61 1QH, UK.
authors.forename: Paul G
authors.initials: PG
authors.lastname: Shiels
authors.affiliation: Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska University Hospital, Huddinge, Karolinska Institutet, SE-14157 Stockholm, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Stenvinkel
mesh_terms: D000375:Aging / Q000235:genetics / Q000502:physiology; D019588:Aging, Premature / Q000209:etiology* / Q000503:physiopathology; D042241:Early Diagnosis; D005260:Female; D005819:Genetic Markers / Q000235:genetics; D006801:Humans; D007113:Immunity, Innate / Q000235:genetics / Q000502:physiology; D007249:Inflammation / Q000150:complications / Q000235:genetics / Q000503:physiopathology; D008297:Male; D009133:Muscular Atrophy / Q000150:complications* / Q000235:genetics; D018384:Oxidative Stress / Q000235:genetics / Q000502:physiology*; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology; D018570:Risk Assessment; D040242:Risk Reduction Behavior; D012720:Severity of Illness Index; D012959:Socioeconomic Factors
chemical_list: D005819:Genetic Markers