Metabolic Basis and Pathogenesis of Skeletal Muscle Dysfunction as Cause of Frailty in Chronic Kidney Disease

Background: Frailty is common in patients with chronic kidney disease (CKD), as is its physical component, phenotypic frailty, and each contributes to CKD-related disability and are associated with increased mortality. Chronic kidney disease has been described as a model of premature aging and its phenotypic frailty shares features with that which has been better characterized for aging. Summary: Decreased skeletal muscle function contributes to the phenotypic frailty of CKD and aging and potentially remediable metabolic derangements appear to mediate both. Key Messages: Metabolic derangements of skeletal muscle dysfunction shared by CKD-related and aging-related phenotypic frailty offer potential research avenues to help identify additional preventive and treatment strategies. Those derangements distinctive for CKD provide potential treatment targets for the kidney care community to enhance the quality and quantity of life for patients with CKD.