Features of pathogenetic mechanisms of protein-energy wasting development in patients with chronic kidney disease stage 5D


DOI: https://dx.doi.org/10.18565/nephrology.2020.4.60-64

A.S. Kuzyarovа, M.Z. Gasanov, M.M. Batyushin, K.R. Bogomolova, I.H. Adamokova

1) OOO Dialysis Center Nephros-Don, Rostov-on-Don, Russia; 2) Rostov State Medical University, Department of Internal Diseases № 1, Rostov-on-Don, Russia; 3) Rostov State Medical University, Department of Internal Diseases № 2, Rostov-on-Don, Russia
Objective. Evaluation of the complex contribution of myostatin (MSTN) and protein kinase-B (Akt) to the development of protein-energy malnutrition in patients with chronic kidney disease (CKD) receiving programmed hemodialysis.
Material and methods. The study involved 80 patients with stage 5D CKD. All subjects underwent general clinical and biochemical examination; the blood serum of MSTN and Akt levels were determined using enzyme-linked immunosorbent assay, and the severity of protein-energy malnutrition (PEM) was assessed using a complex technique.
Results. The prevalence of PEM was 90%. The relationships between the markers of muscle tissue metabolism MSTN and Akt with iron deficiency, hyperparathyroidism, vitamin D deficiency, as well as with indicators of systemic inflammation were determined. To assess the effect of the MSTN/Akt signaling pathway on the development of PEM in hemodialysis patients, an original muscle tissue catabolism index (MTCI) was developed.
Conclusion. MSTN and Akt make a significant contribution to the development of PEM in patients with stage 5D CKD. The proposed MTCI is promising tool in assessing the severity of not only PEM, but also sarcopenia, which is of research interest.
Keywords: chronic kidney disease, protein-energy malnutrition, myostatin, protein kinase-B, sarcopenia

About the Autors


A.S. Kuzyarova – Cand. Sci. (Med.), Nephrologist, OOO Dialysis Center Nephros-Don, Rostov-on-Don, Russia; e-mail: lina.kuzyarova@mail.ru
M.Z. Gasanov – Cand. Sci. (Med.), Associate Professor at the Department of Internal Diseases № 1, Rostov State Medical University, Rostov-on-Don, Russia; e-mail: mitkhat@mail.ru. ORCID: 0000-0001-5856-0404
M.M. Batyushin – Dr. Sci. (Med.), Professor at the Department of Internal Diseases №. 2, Head of the Nephrology Department, Rostov State Medical University, Rostov-on-Don, Russia; e-mail: batjushin-m@rambler.ru. ORCID 0000-0002-2733-4524
K.R. Bogomolova – 4th-year student of the Faculty of Pediatrics, Rostov State Medical University, Rostov-on-Don, Russia; e-mail: bowsaw@mail.ru
I.Kh. Adamokova – 5th-year student of the Faculty of Pediatrics, Rostov State Medical University, Rostov-on-Don, Russia; e-mail: irina_adamokova@mail.ru


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