Protein-energy wasting (PEW) is a common complication of chronic kidney disease (CKD) and is linked to an increased risk of death from cardiovascular illnesses. Despite the fact that even minor renal impairment is an independent predictor of poor cardiovascular prognosis, PEW manifests clinically at a later stage, either before or during dialysis. Loss of muscle protein and fat is caused by a variety of abnormalities that stimulate protein degradation and/or decrease protein synthesis. These abnormalities are not always linked to anorexia, but they are linked to several abnormalities that stimulate protein degradation and/or decrease protein synthesis. Furthermore, data from experimental CKD shows that uremia selectively inhibits the regeneration ability of skeletal muscle stem cells. The loss of kidney excretory and metabolic functions occurs in the course of CKD, along with the activation of endothelial damage, inflammation, acidosis, insulin signalling changes, and anorexia, all of which are believed to orchestrate net protein catabolism and the PEW syndrome.
