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Kidney-care team sheet for anyone with CKD or on dialysis who has been offered MOTS-c
The kidney-failure studies measured the body's own MOTS-c; none gave it. Bring this sheet to your nephrologist or dialysis unit so the team sees your actual kidney results next to the exact product in question.
Your kidney situation
CKD stage or most recent eGFR, with its date
Which eGFR equation the lab usedcreatinine, cystatin C, or both
Dialysis type and schedulehemodialysis days and times, peritoneal dialysis, or none
Kidney transplant history and current anti-rejection medicines
Nephrologist or dialysis unit contact
Recent kidney results
Copy these from your lab reports. Note whether each blood sample was taken before or after a dialysis session.
| Date | eGFR and equation | Creatinine | Cystatin C, if measured | Urine albumin-creatinine ratio | Before or after dialysis |
|---|---|---|---|---|---|
The product you were offered
Name and salt form on the labelfor example free base or acetate
Source and lot number
Who offered it, and the reason given
Any written directions that came with it
Where the kidney evidence stands
- In people with stage 5 CKD, MOTS-c was lower in both skeletal muscle and serum than in age-matched controls.[1]
- In a cohort of 94 people on hemodialysis, circulating MOTS-c was higher than in controls.[2]
- FDA's July 2026 review identified no clinical studies with pharmacokinetic data for MOTS-c, so kidney clearance and dialysis removal are unknown.[3]
- FDA's renal guidance expects a hemodialysis study to include both on- and off-dialysis periods before dosing advice is written.[4]
Questions for the nephrologist or dialysis team
- Which of my current medicines already needed a kidney-based dose change, and how was it worked out?
- Would an unstudied product make changes in my kidney results harder to interpret?
- Do my dialysis schedule or fluid limits change how you would judge a new symptom?
- Is there a treatment with data in kidney disease for the goal I was given?
- Whom should I contact if something changes between visits?
Sources for the facts on this sheet
- Liu C, Gidlund EK, Witasp A, et al. Reduced skeletal muscle expression of mitochondrial-derived peptides humanin and MOTS-C and Nrf2 in chronic kidney disease. Am J Physiol Renal Physiol 2019. PMID 31432706. https://pubmed.ncbi.nlm.nih.gov/31432706/
- Bolignano D, Greco M, Presta P, et al. The Mitochondrial-Derived Peptide MOTS-c May Refine Mortality and Cardiovascular Risk Prediction in Chronic Hemodialysis Patients: A Multicenter Cohort Study. Blood Purif 2024. PMID 39111290. https://pubmed.ncbi.nlm.nih.gov/39111290/
- U.S. Food and Drug Administration. FDA Briefing Document: MOTS-c-Related Bulk Drug Substances (MOTS-c (free base) and MOTS-c acetate), Pharmacy Compounding Advisory Committee, July 23-24, 2026. Accessed 2026-10-18. https://www.fda.gov/media/193347/download
- U.S. Food and Drug Administration, Center for Drug Evaluation and Research. Pharmacokinetics in Patients with Impaired Renal Function: Study Design, Data Analysis, and Impact on Dosing. Guidance for Industry (March 2024). Accessed 2026-10-18. https://www.fda.gov/media/78573/download
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.