About this Research Topic

Background

Metabolic disorders present in chronic kidney disease (CKD) lead to increased protein catabolism resulting in loss of muscle mass and function. Protein catabolism is worsened by other typical conditions, such as diet restrictions, disturbances in appetite-regulating hormones, uremia-related gastrointestinal symptoms, physical inactivity, nutrient malabsorption, and nutrient loss into the dialysate. Therefore, muscle impairment is common among patients with CKD and is associated with higher mortality rates, decreased physical function, and worse clinical status. Obesity is also common among CKD patients. Skeletal muscle metabolism changes occur in obesity as a consequence of systemic and muscle oxidative stress, inflammation, insulin resistance and hormonal alterations. Sarcopenic obesity, a combination of high body fat with muscle depletion, also affects CKD patients and strongly contributes to a worse clinical status compared with either of the two conditions alone. Thus, obese patients who are both uremic and sarcopenic are at high priority for muscle wasting screening, prevention, and treatment.

There have been increased mortality and disability rates of patients with CKD in the last quarter of a century, and the association of poor body composition and functional capacity with low survival. A large research window is therefore still open on the role of diet and exercise/physical activity in improving body composition, mainly related to muscle strength, function and performance of CKD patients, decreasing protein degradation, increasing muscle synthesis or improving muscle mass, strength, function or performance. Filling this gap would be an effort in improving quality of life, survival, and clinical prognosis of CKD patients that suffer from compromised nutritional and functional status or to prevent CKD patients developing such disease burden.

This Research Topic has the purpose of investigating the relationship between nutritional and physical activity strategies, alone or together, in improving body composition or functional capacity related to body muscle compartments, as protein degradation and synthesis, muscle strength and performance, in CKD patients (children, adults or elderly) under non-dialysis dependent treatment, hemodialysis, peritoneal dialysis, or kidney transplant.

Original article, systematic review, review, mini-review, opinion, and clinical trial articles will be welcome. Any research involving diet and/or exercise as exposure in relation to muscle mass, strength, function or performance outcomes in CKD patients will be fully on target. Of particular interest will be the evaluation of such interventions in CKD patients already diagnosed with compromised nutritional or functional status.

Keywords: body composition, body fat, chronic kidney disease, diet, exercise, fat free mass, malnutrition, nutrition, muscle strength, muscle wasting, obesity, physical training, prehabilitation, protein, rehabilitation, sarcopenia, sarcopenic obesity, skeletal muscle

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