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Background: Hemodialysis (HD) patients are vulnerable to multiple metabolic and nutrition derangements, leading to changes in body composition. Handgrip strength (HGS) has been used as a nutrition marker. We aimed to evaluate the relationship between HGS and lean tissue mass (LTM) with several parameters in HD patients and develop HGS predictive equations. Methods: Cross‐sectional study with 155 patients in HD treatment for ≥3 months. Body composition was assessed through bioimpedance spectroscopy. HGS was measured with a hydraulic hand dynamometer. Biochemical parameters were evaluated. Data were analyzed by sex. Results: Ninety‐four were men, and mean age was 64.4 ± 14.7 years. We found positive correlation of HGS with LTM, lean tissue index, and body cell mass and negative correlation between HGS, age, and overhydration in both sexes. Serum albumin level presented a positive correlation and magnesium a negative correlation with HGS only in men. The LTM presented a positive correlation with protein intake, serum albumin level, and body cell mass and a negative correlation with age in both groups. A significant positive correlation with magnesium and a negative correlation with overhydration were observed in men. The predictability of the models was R2 = 0.618 for men and R2 = 0.500 for women. Conclusion: HGS is highly correlated with LTM, and both differ between sexes and are, therefore, differently correlated with the parameters studied. Body composition, overhydration, and some biochemical parameters explain changes in HGS. Predictive models including body composition and biochemical parameters may explain at least 50% of the variance of HGS.

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Currently, a high prevalence of hypophosphatemia exists in Portuguese HD patients. This condition is associated with worst nutritional and body composition parameters. In the context of additional indices of malnutrition (low albumin, low BMI or severe overhydration), hypophosphatemic patients presented higher mortality risk.

Monitoring nutritional parameters is an integral part of hemodialysis (HD) patient treatment program. The purpose of this study was to evaluate the impact of the personalized nutritional counseling (PNC) on calcium-phosphorus metabolism, potassium, albumin, protein intake, interdialytic weight gain (IDWG), body composition parameters and fluid overload in HD patients. This was a multicenter longitudinal intervention study with 6 months of follow-up and 731 patients on maintenance HD from 34 dialysis units in Portugal were enrolled. Biochemical and body composition parameters were measured at baseline, 1, 3 and 6 months after the PNC. Patient's mean age was 64.9 (95% confidence interval [CI]: 63.8-66.0) years and mean HD time was 59.8 (95% CI: 55.3-64.3) months. Regarding data comparison collected before PNC vs. 6 months after, we obtained, respectively, the following results: patients with normalized protein catabolic rate (nPCR) ≥ 1 g/kg/day = 66.5% vs. 73.5% (P = 0.002); potassium > 5.5 mEq/L = 52% vs. 35.8% (P < 0.001); phosphorus between 3.5 and 5.5 mg/dL = 43.2% vs. 52.5% (P < 0.001); calcium/phosphorus (Ca/P) ratio ≤ 50 mg/dL = 73.2 % vs. 81.4% (P < 0.001); albumin ≥ 4.0 g/dL = 54.8% vs. 55% (P = 0.808); presence of relative overhydration = 22.4% vs. 25% (P = 0.283); IDWG > 4.5% = 22.3% vs. 18.2% (P = 0.068). PNC resulted in a significant decrease in the prevalence of hyperkalemia, hypophosphatemia and also showed amelioration in Ca/P ratio, nPCR and an increase in P of hyphosphatemic patients. Our study suggests that dietetic intervention contributes to the improvement of important nutritional parameters in patients receiving hemodialysis treatment.