Article: PDF OnlyMitch William E.Current Opinion in Nephrology and Hypertension: November 1995 - p 488-492 Buy Abstract Mechanisms causing loss of lean body mass in uremia include an inability to activate metabolic adaptations to a low-protein diet caused by anorexia, or other factors. The adaptations include decreased degradation of essential amino acids and protein. Metabolic acidosis activates specific pathways which increase catabolism by mechanisms that include stimulation of genes. The inability to adapt to dietary protein restriction causes loss of lean body mass. © Lippincott-Raven Publishers.