FIGURE 1.

Overview of myogenesis and regulatory processes and the possible effect of CKD. Arrows denote stimulatory/upregulatory impact and flat lines indicate negative/suppressive impact. SCs are activated by stimuli such as exercise and damage. Proliferating cells and myoblasts either return to quiescence or differentiate to become myocytes. Mature myocytes fuse to each other or existing myotubes, providing new myonuclei. CKD interferes with both proliferation and differentiation of SCs with factors including inflammation, myostatin signalling and IGF-1/Akt dysregulation proposed as primary mechanisms. See text for details.