This study was performed to assess the mRNA levels in skeletal muscle of maintenance hemodialysis (MHD) patients. Fifty-one sedentary MHD patients and 21 sedentary normal adults of similar age, gender distribution, and racial/ethnic mix as the patients were examined. The subjects had needle muscle biopsy to measure mRNA levels. They were assessed in right vastus lateralis muscle for insulinlike growth factor I (IGF-IEa and IGF-IEc), IGF-II, the IGF-I receptor, the IGF-II receptor, and myostatin. mRNA was measured by real-time polymerase chain reaction amplification of reverse transcribed cDNA. The results showed that in the MHD patients, as compared with the normal control patients, skeletal muscle mRNA levels for IGF-IEa, IGF-II, and the IGF-I receptor were significantly reduced, whereas mRNA for IGF-IEc, IGF-II receptor, and myostatin were not different than normal. We conclude that sedentary MHD patients show reductions in mRNA levels in the right vastus lateralis muscle for certain growth factor proteins, notably IGF-IEa, IGF-II, and the IGF-I receptor. These abnormalities may contribute to the sarcopenia and impaired endurance capacity, strength, and physical performance that occur in MHD patients.