Abstract: PUB244
Uraemic Sarcopenia in CKD: Burden, Prognostic Significance, and Evolving Therapeutic Approaches
Session Information
Category: CKD (Non-Dialysis)
- 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Fahal, Fayez, Barking, Havering and Redbridge University Hospitals NHS Trust, London, United Kingdom
- Fahal, Ibrahim Hassan, Barking, Havering and Redbridge University Hospitals NHS Trust, London, United Kingdom
Background
Sarcopenia, characterised by progressive loss of skeletal muscle strength, mass, and physical performance, is highly prevalent in patients with Chronic kidney disease (CKD). In this population, “uraemic sarcopenia” arises from a complex interplay of chronic inflammation, metabolic acidosis, hormonal imbalance, insulin resistance, uraemic toxin accumulation, and dialysis-related catabolism. These factors accelerate muscle degradation, contributing to frailty, reduced quality of life, and increased morbidity and mortality.
Our objective is to synthesise evidence on epidemiology, prognostic impact, and management in CKD, with a focus emerging therapeutic strategies.
Methods
A narrative review of recent systematic reviews, meta-analyses, and pivotal observational studies was conducted. Data on prevalence across CKD stages, diagnostic frameworks, pathophysiological mechanisms, and therapeutic interventions were critically evaluated.
Results
Global prevalence of sarcopenia in CKD is estimated at 24.5%, increasing to approximately 50% in dialysis populations. Reduced muscle strength is the most common presenting feature, affecting up to 43% of patients. Sarcopenia is an independent predictor of frailty, hospitalisation, cardiovascular events, mortality, and adverse post-transplant outcomes. Standardised diagnostic criteria e.g. EWGSOP2 facilitate early recognition. Current management strategies include combined exercise programmes, nutritional optimisation, correction of metabolic acidosis, and dialysis adequacy. Novel pharmacological approaches, e.g. myostatin/activin-A inhibitors, selective androgen receptor modulators, and ghrelin agonists, are under active investigation.
Conclusion
Uraemic sarcopenia represents a common and clinically consequential complication of CKD, with significant prognostic implications. Early diagnosis and a multimodal management strategy incorporating exercise, nutrition, metabolic optimisation, and emerging pharmacotherapies are essential to improve patient outcomes. Integration of routine sarcopenia screening into nephrology practice is warranted to mitigate disease burden.