title: [Muscle-wasting in end stage renal disease in dialysis treatment: a review].
abstract: Progressive and generalized loss of muscle mass (muscle wasting) is a frequent complication in dialysis patients. Common uremic signs and symptoms such as insulin-resistance, increase in glucocorticoid activity, metabolic acidosis, malnutrition, inflammation and dialysis per se contribute to muscle wasting by modulating proteolytic intracellular mechanisms (ubiquitin-proteasome system, activation of caspase-3 and IGF-1/PI3K/Akt pathway). Since muscle wasting is associated with an increase in mortality, bone fractures and worsening in life quality, a prompt and personalised diagnostic and therapeutic approach seems to be essential in dialysis patients. At present, nuclear magnetic resonance (NMR), computed tomography (CT), dual-energy x-ray absorptiometry (DXA), impedance analysis, bioelectric impedance analysis (BIA) and anthropometric measurements are the main tools used to assess skeletal muscle mass. Aerobic and anaerobic training programmes and treatment of uremic complications reduce muscle wasting and increase muscle strength in uremic patients. The present review analyses the most recent data about the physiopathology, diagnosis, therapy and future perspectives of treatment of muscle wasting in dialysis patients.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Battaglia
authors.forename: Dario
authors.initials: D
authors.lastname: Galeano
authors.forename: Elena
authors.initials: E
authors.lastname: Cojocaru
authors.forename: Fulvio
authors.initials: F
authors.lastname: Fiorini
authors.forename: Silvia
authors.initials: S
authors.lastname: Forcellini
authors.forename: Luca
authors.initials: L
authors.lastname: Zanoli
authors.forename: Alda
authors.initials: A
authors.lastname: Storari
authors.forename: Antonio
authors.initials: A
authors.lastname: Granata
mesh_terms: D053148:Caspase 3 / Q000378:metabolism; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000628:therapy; D009133:Muscular Atrophy / Q000209:etiology / Q000378:metabolism* / Q000473:pathology* / Q000517:prevention & control; D046988:Proteasome Endopeptidase Complex / Q000378:metabolism; D006435:Renal Dialysis / Q000009:adverse effects*
chemical_list: D007334:Insulin-Like Growth Factor I; D053148:Caspase 3; D046988:Proteasome Endopeptidase Complex