Abstract
Chronic kidney disease (CKD) is a prevalent worldwide public burden that increasingly compromises overall health as the disease progresses. Two of the most negatively affected tissues are bone and skeletal muscle, with CKD negatively impacting their structure, function and activity, impairing the quality of life of these patients and contributing to morbidity and mortality. Whereas skeletal health in this population has conventionally been associated with bone and mineral disorders, sarcopenia has been observed to impact skeletal muscle health in CKD. Indeed, bone and muscle tissues are linked anatomically and physiologically, and together regulate functional and metabolic mechanisms. With the initial crosstalk between the skeleton and muscle proposed to explain bone formation through muscle contraction, it is now understood that this communication occurs through the interaction of myokines and osteokines, with the skeletal muscle secretome playing a pivotal role in the regulation of bone activity. Regular exercise has been reported to be beneficial to overall health. Also, the positive regulatory effect that exercise has been proposed to have on bone and muscle anatomical, functional, and metabolic activity has led to the proposal of regular physical exercise as a therapeutic strategy for muscle and bone-related disorders. The detection of bone- and muscle-derived cytokine secretion following physical exercise has strengthened the idea of a cross communication between these organs. Hence, this review presents an overview of the impact of CKD in bone and skeletal muscle, and narrates how these tissues intrinsically communicate with each other, with focus on the potential effect of exercise in the modulation of this intercommunication.
Highlights
Chronic kidney disease (CKD) has recently been defined as a ‘model of accelerated aging’, influencing the human body in a patently comparable fashion to aging, with an elevatedUniversity of Illinois At Urbana-Champaign, Champaign, IL, USA liability for locomotor disorders, fractures, falls, and limited mobility, loss of function, and frailty [1, 2]
Despite earlier research on skeletal health focusing upon bone and mineral abnormalities, recently it has been recognized that sarcopenia has a major role in reduced musculoskeletal health in CKD [6, 7]
This is evident in advanced stages of the disease [10], with this compromised skeletal muscle health increasing the risk of mortality in CKD
Summary
Chronic kidney disease (CKD) has recently been defined as a ‘model of accelerated aging’, influencing the human body in a patently comparable fashion to aging, with an elevated. Muscle and bone act in parallel to support and regulate the muscles’ functions in order to produce strength and exert forces to allow for functional independence [7, 12]. This led to the development of the term ‘bone-muscle unit’ in the late 90’s, strengthened by the linear association between total body mineral content and lean mass reported in a large study of individuals (n = 1450) ranging from 2 to 87 years of age [13]. This review focuses on the cross communication between muscle and bone, seeking to highlight the potential modulatory effect of exercise on these tissues, highlighting its usefulness as a novel therapeutic strategy to improve muscle and bone parameters, and overall health and quality of life in patients with CKD
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