THE ROLE OF MYOSTATIN AND PROTEIN KINASE-B IN THE DEVELOPMENT OF PROTEIN-ENERGY DEFICIENCY IN PATIENTS WITH END-STAGE RENAL DISEASE ON HEMODIALYSIS.

ABSTRACT

In patients with chronic renal failure receiving hemodialysis, the development of protein-energy wasting (PEW) has a significant impact on the quality and duration of life. Myostatin (MSTN) and protein kinase-ß (AKT) play an important role in this process. The aim of our study was to assess the contribution of these molecular markers of muscle metabolism to the development of PEW in patients with chronic kidney disease stage 5D (CKD5D). The study included 80 patients with CKD5D. All patients underwent anthropometric research, hand dynamometry, bio-impedancemetry. MSTN and AKT levels were determined in the blood by ELISA. In the study, the prevalence of PEW was 90%. We have proposed a catabolic muscle tissue index (CMTI), which takes into account the complex effect of the relationship between MSTN and AKT on the development of PEW. An increase in this index in degrees from 0-2 characterizes the prevalence of catabolic processes in muscle tissue. There is an increase in CMTI with the progression of nutritional disorders in patients on hemodialysis (HD). An increase in CMTI is associated with a decrease in muscle strength, muscle mass (measured by the diameter of the shoulder). No correlation was found between CMTI and gender, age, or bio-impedance indicators, which requires further investigation.