Pilot study of 32 chronic peritoneal dialysis patients measuring MOTS-c in serum, urine, and dialysate, and correlating levels with sarcopenia risk assessed by SARC-F, anthropometrics, and physical performance. Examines MOTS-c balance in end-stage kidney disease on dialysis, where sarcopenia is highly prevalent. Provides the first MOTS-c data in peritoneal dialysis patients—establishing whether mitochondrial peptide deficiency contributes to the high sarcopenia burden in ESKD and whether MOTS-c represents a novel therapeutic or monitoring target in dialysis-associated muscle wasting.
Abstract
Sarcopenia is exceedingly frequent in end-stage kidney disease (ESKD) patients on dialysis, including those undergoing peritoneal dialysis (PD), and is of multifactorial origin. MOTS-c is a mitochondrial-derived peptide that promotes muscle growth whose levels are unbalanced in ESKD. In this study, we evaluated MOTS-c balance and its relationship with sarcopenia risk in an ESKD-PD cohort.MOTS-c was measured in serum, urine, and dialysate samples of 32 chronic PD patients. Patients were thus screened for sarcopenia risk by the SARC-F tool, anthropometric measurements, and physical performance tests.PD patients with a very high sarcopenia risk (SARC-F ≥ 2) had significantly lower serum (sMOTS-c) and higher dialysate (dMOTS-c) levels, suggesting an increased peritoneal clearance of this substance (d/s MOTS-c). sMOTS-c levels were directly correlated with muscle performance in physical tests, while an opposite relationship was found with dMOTS-c and d/sMOTS-c. ROC analyses demonstrated the diagnostic potential of MOTS-c, particularly in combination with physical and anthropometric assessments, to identify PD patients at very high risk of sarcopenia.Chronic PD may negatively affect MOTS-c balance, which, in turn, may contribute to enhanced sarcopenia risk. Larger studies are needed to confirm these observations and to validate the potential utility of this substance as a biomarker for improving sarcopenia risk stratification in PD patients.