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Frailty, sarcopenia and diabetic kidney disease: where do we stand?

  • Nephrology - Review
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Abstract

The aim of this narrative non-systematic review was to investigate the potential interplay among frailty syndrome, sarcopenia and diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM) patients. Data derived from a limited number of studies underline that DKD is a significant risk factor for frailty. On the other hand, frailty syndrome poses a higher risk for end-stage renal disease (ESRD) in subjects with DKD. In addition, frailty seems to affect the cognitive function and social life of DKD individuals, whilst as DKD deteriorates, there is a higher prevalence of sarcopenia which is a fundamental frailty factor. As a result, it is shown that a bidirectional relation is established between these entities, as diabetes mellitus (DM) affects the components of frailty and sarcopenia and vice versa. This vicious cycle is created through multiple pathophysiologic mechanisms, including the anabolic role of insulin, low-grade inflammation, cytokines and endothelial function, prompting further investigation in this area. Specific nutritional and exercise interventions are imperative to be established in order to ameliorate potential adverse outcomes, concerning these entities.

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Author notes

  1. Nikolaos D. Karakousis and Smaragda Biliou have contributed equally as first authors.

Authors and Affiliations

  1. Primary Healthcare, Internal Medicine Department, Amarousion, Attica, Greece

    Nikolaos D. Karakousis & Petros N. Georgakopoulos

  2. Internist, Private Practice, Attica, Greece

    Smaragda Biliou

  3. Pharmacist, Private Practice, Attica, Greece

    Elisavet E. Pyrgioti

  4. Division of Nephrology and Hypertension, First Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Vassilios Liakopoulos

  5. Diabetes Centre-Diabetic Foot Clinic, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece

    Nikolaos Papanas

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  1. Nikolaos D. Karakousis
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  2. Smaragda Biliou
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  3. Elisavet E. Pyrgioti
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  4. Petros N. Georgakopoulos
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Karakousis, N.D., Biliou, S., Pyrgioti, E.E. et al. Frailty, sarcopenia and diabetic kidney disease: where do we stand?. Int Urol Nephrol 55, 1173–1181 (2023). https://doi.org/10.1007/s11255-022-03392-1

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