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慢性肾脏病中的肌肉减少症

Sarcopenia in chronic kidney disease.

作者信息

Souza Viviane Angelina de, Oliveira Dílmerson de, Mansur Henrique Novais, Fernandes Natália Maria da Silva, Bastos Marcus Gomes

机构信息

Universidade Federal de Juiz de Fora, Brasil.

Universidade Federal do Pernambuco, Brasil.

出版信息

J Bras Nefrol. 2015 Jan-Mar;37(1):98-105. doi: 10.5935/0101-2800.20150014.

Abstract

Sarcopenia is a chronic condition associated with physiological aging process and is defined by the reduction of the mass, muscle strength and function. In Chronic Kidney Disease (CKD), sarcopenia is prevalent and is associated with increased morbidity and mortality and the occurrence of cardiovascular complications. By analyzing sarcopenia in patients with renal insufficiency, complex mechanisms that contribute to loss of muscle mass are highlighted, such as activation of mediators that stimulate the ubiquitin-proteasome system (SUP) ATP-dependent, inflammation, metabolic acidosis, angiotensin II and some hormonal factors. The therapeutic approach to sarcopenia in CKD includes exercises, correction of metabolic acidosis, hormone replacement therapy and insulin resistance. Thus, it is of paramount importance early recognition of sarcopenia in this population, in order to establish effective therapeutic interventions, thus avoiding the full range of complications associated with muscle wasting in CKD.

摘要

肌肉减少症是一种与生理衰老过程相关的慢性疾病,其定义为肌肉质量、力量和功能的下降。在慢性肾脏病(CKD)中,肌肉减少症很常见,并且与发病率和死亡率的增加以及心血管并发症的发生有关。通过分析肾功能不全患者的肌肉减少症,导致肌肉质量丧失的复杂机制得以凸显,例如刺激ATP依赖型泛素-蛋白酶体系统(SUP)的介质激活、炎症、代谢性酸中毒、血管紧张素II和一些激素因素。CKD中肌肉减少症的治疗方法包括运动、代谢性酸中毒的纠正、激素替代疗法和胰岛素抵抗。因此,对于这一人群早期识别肌肉减少症至关重要,以便建立有效的治疗干预措施,从而避免与CKD中肌肉消耗相关的一系列并发症。

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