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Impaired muscle mitochondrial energetics is associated with uremic metabolite accumulation in chronic kidney disease
Trace Thome, Ravi A. Kumar, Sarah K. Burke, Ram B. Khattri, Zachary R. Salyers, Rachel C. Kelley, Madeline D. Coleman, Demetra D. Christou, Russell T. Hepple, Salvatore T. Scali, Leonardo F. Ferreira, Terence E. Ryan
Trace Thome, Ravi A. Kumar, Sarah K. Burke, Ram B. Khattri, Zachary R. Salyers, Rachel C. Kelley, Madeline D. Coleman, Demetra D. Christou, Russell T. Hepple, Salvatore T. Scali, Leonardo F. Ferreira, Terence E. Ryan
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Research Article Muscle biology Nephrology

Impaired muscle mitochondrial energetics is associated with uremic metabolite accumulation in chronic kidney disease

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Abstract

Chronic kidney disease (CKD) causes progressive skeletal myopathy involving atrophy, weakness, and fatigue. Mitochondria have been thought to contribute to skeletal myopathy; however, the molecular mechanisms underlying muscle metabolism changes in CKD are unknown. We employed a comprehensive mitochondrial phenotyping platform to elucidate the mechanisms of skeletal muscle mitochondrial impairment in mice with adenine-induced CKD. CKD mice displayed significant reductions in mitochondrial oxidative phosphorylation (OXPHOS), which was strongly correlated with glomerular filtration rate, suggesting a link between kidney function and muscle mitochondrial health. Biochemical assays uncovered that OXPHOS dysfunction was driven by reduced activity of matrix dehydrogenases. Untargeted metabolomics analyses in skeletal muscle revealed a distinct metabolite profile in CKD muscle including accumulation of uremic toxins that strongly associated with the degree of mitochondrial impairment. Additional muscle phenotyping found CKD mice experienced muscle atrophy and increased muscle protein degradation, but only male CKD mice had lower maximal contractile force. CKD mice had morphological changes indicative of destabilization in the neuromuscular junction. This study provides the first comprehensive evaluation of mitochondrial health in murine CKD muscle to our knowledge and uncovers several unknown uremic metabolites that strongly associate with the degree of mitochondrial impairment.

Authors

Trace Thome, Ravi A. Kumar, Sarah K. Burke, Ram B. Khattri, Zachary R. Salyers, Rachel C. Kelley, Madeline D. Coleman, Demetra D. Christou, Russell T. Hepple, Salvatore T. Scali, Leonardo F. Ferreira, Terence E. Ryan

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Figure 2

CKD impairs mitochondrial energy transduction and correlates with kidney function.

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CKD impairs mitochondrial energy transduction and correlates with kidney...
Skeletal muscle mitochondria were isolated from control and CKD mice. (A) Maximal ADP-stimulated respiration supported by pyruvate and malate (Pyr/Mal) was significantly decreased in male CKD mice (n = 5–6/group/sex). (B) Next, a physiological assessment of mitochondrial OXPHOS was employed using a creatine kinase clamp (C) to establish physiologically relevant levels of extramitochondrial energy demand (i.e., mimic a stress test). (D) Male and female mitochondrial oxygen consumption (JO2) plotted against energy demand (ΔGATP) for the following substrate conditions: pyruvate + malate, glutamate + malate, succinate + rotenone, and fatty acid (FA, octanoyl-carnitine + malate) (n = 5–7/group/sex). (E) Quantification of OXPHOS conductance for each substrate condition (slope of JO2 vs. ΔGATP) (n = 5–7/group/sex). (E) Pearson correlation analysis of OXPHOS conductance and GFR demonstrate a strong association between kidney function and mitochondrial OXPHOS in skeletal muscle. Data were analyzed by multiple 2-tailed Student’s t test (D) or 2-way ANOVA with Tukey’s post hoc testing when an interaction was detected (A and E). Error bars show standard deviation. *P < 0.05, **P < 0.01, and ****P < 0.0001. NS, not significant.

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