Research advances in the mechanisms of indoxyl sulfate and sarcopenia in chronic kidney disease

Sarcopenia in chronic kidney disease （CKD） occurs mainly in patients with end-stage renal disease （ESRD） on hemodialysis. The potential causes are insufficient nutrition intake, protein and energy consumption, inflammatory cytokines, oxidative stress, insulin resistance and uremic toxins. Protein-bound uremic toxin phenol sulfate is an intestinal-derived uremic toxin accumulating in CKD patients. It is difficult to remove through dialysis. It affects the occurrence of sarcopenia through various ways. The review focused upon the mechanisms of sarcopenia caused by indoxyl sulfate.