[The triple whammy of muscle loss, osteoporosis and vascular calcification in chronic kidney disease patients calls out the need for novel treatment strategies].

Chronic kidney disease (CKD) is characterized by numerous metabolic, nutritional and cardiovascular complications including loss of muscle mass, osteoporosis and vascular calcification contributing to the high mortality among these patients. Factors involved in the underlying pathology processes resulting in these complications such as insulin-like growth factor-1 system, calcium and phosphate homeostasis, fibrosis growth factor-23/parathyroid hormone pathway, receptor activator of nuclear-factor B system and osteoprotegerin pathway are closely interrelated and may act synergistically. Thus, the regulation of protein degradation, bone loss and vascular calcification share several common mediators and mechanisms, underlining the need for research approaches focusing on these shared mechanisms and pathways. This brief review aims at summarizing advances in our current understanding of the basis for development of muscle loss, osteoporosis and vascular calcification and also the possible connections among them in the CKD patients.