MSTN and chronic kidney disease: Elevated Mstn gene expression has also been observed in the vascular wall of CKD patients, where it is accompanied by the upregulation of atrogin-1 and MuRF-1, members of E3 ligases and major effectors of protein degradation, increased expression of CCL2/MCP-1, and decreased expression of cytoskeleton proteins and Klotho [75].