Age, diabetes mellitus, and dialysis modality are associated with risk of poor muscle strength and physical function in hemodialysis and peritoneal dialysis patients

Abstract

Background: Due to the poor outcomes associated with the impairment of physical function and muscle strength in patients on maintenance dialysis, it is important to understand the factors that may influence physical function and muscle strength. The aim of this study was to explore the factors associated with physical function in hemodialysis and peritoneal dialysis patients. Methods: Patients with chronic kidney disease on dialysis for at least 3 months, aged 18 years old or above, were enrolled. Physical function was assessed by handgrip strength, gait and sit-to-stand tests, and the Short Physical Performance Battery (SPPB). Clinical and laboratory data were collected to verify the association with physical function parameters through binary logistic regression. Results: One-hundred ninety patients on maintenance dialysis were included; 140 patients (73.7%) on hemodialysis and 50 (26.3%) on peritoneal dialysis. The mean age was 57.3 ± 14.9 years, 109 (57.4%) were male, and 87 (45.8%) were older than 60 years. The median SPPB was 8.0 points (6.0-10.0 points) and the mean ± standard deviation of handgrip strength was 24.7 ± 12.2 kg. Binary logistic regression showed that age, type of renal replacement therapy, diabetes mellitus, and serum creatinine were significantly associated with both higher 4-meter gait test times and lower SPPB scores. Only age and diabetes mellitus were associated with higher sit-to-stand test times, while age and ferritin were associated with lower handgrip strength. Conclusion: Age, diabetes mellitus, serum creatinine, and hemodialysis modality are factors related to physical function in dialysis patients.

Prevalence of Sarcopenia and Its Impact on Cardiovascular Events and Mortality among Dialysis Patients: A Systematic Review and Meta-Analysis

“…First of all, ESKD patients who chose PD rather than HD modality seemed to have a better health status as a result of younger age, less comorbidity and greater physical independence [ 63 ]. Moreover, the influence of each KRT modality on sarcopenia might be related to several issues including daily routine and the patient’s level of physical activity [ 64 ]. Most PD patients spend most of their time out of the healthcare center.…”

Relationship between physical performance and mild cognitive impairment in elderly hemodialysis patients is modified by the presence of diabetes: A multicenter cross-sectional study

“…Although another comparison of physical performance between the groups according diabetes showed lower physical performance in the diabetes group than the non-diabetes group of hemodialysis and peritoneal dialysis patients (33), however, so far, no research has shown that physical activity is significantly worse in the coexistence of diabetes and MCI diseases. Furthermore, results of our study found that the prevalence of MCI in diabetic hemodialysis patients was high (20.6%).…”

Short-Physical Performance Batter：Complete Mediator of Cognitive Depressive Symptoms and Diabetes Mellitus in Hemodialysis Patients

“…Speci cally, previous research [9] suggested that under conditions of low physical performance, an association with DM was evident, while such a relationship did not manifest under high levels of physical performance. Moreover, studies revealed that hemodialysis itself was a factor linked to impaired physical performance in patients with chronic kidney disease (CKD) [25,27]. It was crucial to note that participants in the study by Navaneethan et al had CKD stages 3-5 and were not receiving maintenance dialysis, whereas our study focused on individuals undergoing maintenance hemodialysis for a minimum of three months.…”