Chronic kidney disease leads to muscle fibrosis—the stiffening and scarring of muscle tissue. But it’s not clear whether this fibrosis occurs only with severe disease or is instead an insidious and potentially treatable process that begins with early loss of kidney function.

In a study involving patients with chronic kidney disease at Montefiore Medical Center, Matthew Abramowitz, M.D., M.S., and colleagues used transcriptome profiling (analyzing the expression levels of mRNAs) before and after dialysis to assess the molecular underpinnings of chronic kidney disease-associated fibrosis in skeletal muscle. The researchers found that muscle fibrosis was accompanied by impaired regenerative capacity of the muscle and lower vascular density and that fibrosis markedly improved after dialysis started. The findings suggest that the period following the start of dialysis presents a unique opportunity for interventions such as exercise and nutrition to preserve and improve skeletal muscle health. The study was published online on November 16 in JCI Insight.

Dr. Abramowitz is associate professor of medicine at Einstein and a nephrologist at Montefiore.