MEDICAL AREA   

Medicina dello Sport 2018 September;71(3):370-92

DOI: 10.23736/S0025-7826.18.03389-6

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English, Italian

Beneficial effects of physical activity on uremic sarcopenia

Annalisa NOCE ¹, Giulia MARRONE ^{1, 2}, Valentina ROVELLA ¹, Annalisa CUSUMANO ¹, Nicola DI DANIELE ¹ ✉, Maurizio CASASCO ³

¹ Department of Systems Medicine, UOC of Internal Medicine, Center of Hypertension and Nephrology Unit, Tor Vergata University, Rome, Italy; ² PhD School of Applied Medical-Surgical Sciences, Tor Vergata University, Rome, Italy; ³ Italian Sports Medicine Federation (FMSI), Rome, Italy

Uremic sarcopenia induces worsening of the clinical features and the quality of life in nephropathic patients and it is associated with an increased mortality and morbidity for all causes. In particular, in this clinical condition, an atrophy of type II muscle fibers is observed. To diagnose sarcopenia, it is necessary to evaluate muscle mass, resistance to physical exercise and muscle strength. Currently, to contrast onset and progression of sarcopenia in nephropathic patients, it is recommended to perform adequate levels of physical activity dependent on the stage of renal function and on the clinical features of the patient. Several studies have shown that physical activity is able to improve both in uremic patients under conservative therapy and in transplant patients, strength and resistance to aerobic exercise without having any impact on renal function. In dialysis, the scheduled physical activity is able to improve the aerobic capacity and specifically intradialitic exercises are able to ameliorate protein metabolism, the ability to remove toxins and consequently the dialytic efficiency. In addition to physical activity, traditional therapeutic strategies useful in the improvement of sarcopenia include: vitamin and hormone supplementation and anti-inflammatory drugs. Other unconventional therapies are mitochondrial stimulation, the use of stem cells and the genetic manipulation of the TGF-β family.

KEY WORDS: Sarcopenia - Kidney diseases - Physical activity