Proteolytic Mechanisms, Not Malnutrition, Cause Loss of Muscle Mass in Kidney Failure

摘要: Hypoalbuminemia and muscle atrophy are frequently found in patients with chronic kidney disease (CKD) being treated by dialysis. These abnormalities usually attributed to malnutrition, meaning that they caused an inadequate diet. However, the evidence indicates malnutrition is rarely mechanism causing loss of protein stores. Instead, low values serum albumin closely related presence inflammation mass attributable activation specific proteases. In uremic rodents patients, initial step caspase-3. This cleaves complex structure muscle, its action can be detected a characteristic 14-kDa actin fragment insoluble fraction muscle. The second uremia-induced ubiquitin-proteasome system, which rapidly degrades proteins released caspase-3 cleavage proteins. Activation both system occur when there suppression cellular signaling pathway activated insulin/insulinlike growth factor 1, phosphatidylinositol 3-kinase/Akt pathway. A potential therapeutic target for preventing stimulate activity this