INS and chronic kidney disease: Sarcopenia, which is characterized by a progressive decline of skeletal muscle mass, strength, and physical performance, is frequently observed in patients with chronic kidney disease (CKD) and leads to poor clinical outcomes (1–3), as pathogenic factors—metabolic acidosis, inflammation, impaired insulin signaling, oxidative stress, accumulated uremic toxins, suppressed appetite, decline in satellite cells, and myostatin overexpression—accelerate skeletal muscle wasting as kidney disease progresses (4, 5).