Protein-energy wasting (PEW) is increasingly recognized to be a prevalent and significant contributor to the clinical deterioration of patients with chronic kidney disease (CKD). While factors reflecting various aspects of PEW correlate with outcomes in CKD, the mechanism linking PEW and CKD outcomes is not completely understood. Plasma gelsolin (pGSN) is a highly abundant circulating protein that is depleted by inflammatory mediators and mainly produced by muscles. Recent data documenting the prognostic ability of low pGSN levels in hemodialysis patients suggests that circulating pGSN levels incorporate the degree of systemic inflammation and muscle wasting. Therefore, pGSN deficiency appears to be a powerful biomarker and a potential therapeutic target in CKD patients.
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