الفهرس 
Chronic kidney diseaseOnly 14 pages are availabe for public view
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Abstract
Chronic kidney disease (CKD) is a progressive condition that might negatively affect musculoskeletal health. Secondary sarcopenia due to chronic kidney disease may be accompanied with elevated fall risk and mobility limitations. The loss of muscle mass, in addition to the impact of poor body composition on muscle strength and mobility status are necessary for classification and staging of sarcopenia.
Patients with chronic kidney disease are prone to muscle wasting. Thus, it is important to investigate suitable methods for the clinical assessment of muscle mass. The hemodialysis was found to stimulate protein degradation and reduced protein synthesis for 2hr following dialysis, suggested that a process causing protein loss was initiated by this therapy and persisted. Increasing the intake of protein and calories could improve protein turnover but, it did not fully correct the responses to hemodialysis.
Patients with chronic kidney disease are subjected to muscle wasting. So, it was important to investigate surrogate methods that enable the assessment of muscle mass loss in the clinical setting. Myostatin is the major negative regulator of growth that is highly enriched in skeletal muscle. There was great interest in myostatin as a potential mediator of sarcopenia as well as a therapeutic target.
The recent advent of interferon-free direct-acting antiviral (DAA) represents a marked change in therapy against hepatitis C virus (HCV), and excellent sustained virologic response (SVR) rates have been demonstrated.
Thus, in almost all patients, it is possible to eradicate HCV without unpleasant side effects, which have a negative impact on (quality of life) during interferon-based treatment. In patients with SVR, the progression of liver disorder has been reported to markedly improve. However, the effect of an SVR on the skeletal muscle has not been clarified.
The main aim of this study was to assess the effect of direct anti-viral drugs on myostatin level and its correlation with sarcopenia in CRF patient with chronic HCV.
This was a case control study was conducted at gastroenterology outpatients’ clinics and internal medicine and nephrology department Ain Shams university hospital and om elmasryeen general hospital including 50 chronic renal failure patients with chronic HCV infection and normal persons; they were divided into: group A: 20 chronic HCV patient received direct acting anti-viral drugs. group B: 20 chronic HCV patients didn’t receive direct acting anti-viral drugs. group C: 10 normal persons without chronic renal failure or hepatitis C virus. The duration of the study ranged from 6-12 months.
The main results of the study revealed that:
There was no statistically significant difference between the studied groups as regard demographic data.
There was high statistically significant difference between the studied groups as regard weight, lean body mass and BMI.
There was high statistically significant difference between the studied groups as regard Hb.
There was high statistically significant difference between the studied groups as regard history of ALT and AST and significant difference between the two studied groups as regards Alpha fetoprotein.
There was high statistically significant difference between the studied groups as regard history of BUN and significant difference between the two studied groups as regards Creatinine.
There was statistically significant difference between the studied groups as regard Serum myostatin.
Based on our findings, we recommend for further studies on larger sample size and on large geographical scale to emphasize our conclusion.