Figure 7. Proposed Scheme: CKD-induced stimulation of SIRP-α impairs insulin signaling and induces muscle wasting.
CKD-induced cytokines stimulate NF-κB activation, allowing for increased expression of SIRP-α proteins. Stimulation of SIRP-α triggers tyrosine de-phosphorylation of IRS-1 and insulin receptor, leading to a reduction in p-Akt and finally muscle protein loss.