Association of gait speed and grip strength with risk of cardiovascular events in patients on haemodialysis: a prospective study

Abstract

Background Gait speed (GS) and handgrip strength (HGS), both factors associated with frailty and sarcopenia, are reportedly associated with CV events in the general population. However, little is known about the impact of these factors on the outcome of patients on dialysis. This study aimed to evaluate whether evaluation of GS and HGS could be associated the onset of fatal/non-fatal cardiovascular (CV) events in patients on haemodialysis (HD). Methods One-hundred-eighty-two patients with end-stage renal disease (ESRD) undergoing HD at four dialysis clinics in April 2015 provided written informed consent to participate in the study. We excluded patients who had physical disability, were unable to walk without help, or had recently experienced CV events. Usual GS over a 4-m walk and HGS were measured at baseline, and 173 patients (men, 124; women, 49) were divided into sex-specific quartiles according to GS and HGS and were followed-up for fatal/non-fatal CV events for a median of 2 years. We examined the association of GS and HGS with CV events and determined cut-off values using Cox regression analysis adjusted for age, sex, HD duration, history of CVD, and diabetes. Results During the follow-up period, 46 CV events occurred. Both physical performance factors were significantly associated with CV events. Low GS (< 0.82 m/s for men and 0.81 m/s for women) and weak HGS (< 29.0 kg for men and 19.7 kg for women) were associated with CV events. For low vs. high GS, the hazard ratio (HR) for CV events was 2.29 [95% confidence interval (CI): 1.20–4.33; P = 0.01], and for low vs. high HGS, the HR was 2.15 [95% CI: 1.00–5.04; P < 0.05]. These HRs remained significant after adjusting for confounding factors, such as sex, age, dialysis vintage, history of CV disease, and diabetes. Conclusions Slow GS and weak HGS in patients on HD were suggested to be independent predictors of fatal/non-fatal CV events. Electronic supplementary material The online version of this article (10.1186/s12882-019-1370-6) contains supplementary material, which is available to authorized users.

Handgrip Strength and Mortality in Maintenance Hemodialysis Patients

“…As an observational study, it is im-possible to exclude the possibility that the results were influenced by nonmeasured confounding factors. Some studies have suggested that weak HGS is an important predictor of cardiovascular events in both MHD patients and the general population (28)(29)(30). However, we could not examine the relationship between HGS and disease-specific mortality, especially cardiovascular disease, because the exact causes of death were lacking.…”

Índice de Masa Corporal, Velocidad de Marcha y Fuerza de Prensión Manual en Mujeres Mayores Chilenas (Body Mass Index, Gait Speed and Manual Pressure Force in Chilean Older Women)

“…En general, las evidencias científicas reportan un detrimento de la condición funcional de los adultos a medida que envejecen, o sea, presentan reducción del estado de acondicionamiento físico y de la capacidad para la realización actividades de la vida diaria y que el ejercicio físico ha demostrado ser una estrategia eficaz para atenuar esta condición (Mendonca et al, 2016), por lo que el control y evaluación de la condición es factor fundamental para la compresión de los beneficios de los programas de actividad física. Partiendo de ese concepto, estudios han presentado resultados considerados como punto de corte para el desempeño en la VM y PM lo que puede representar situación contextualizada de aumentado para riesgo de caídas y de la condición física global, respectivamente (Chou et al, 2019;Cruz-Jentoft et al, 2019;Kuki et al, 2019;Sallinen et al, 2010). Sumado a eso, las recomendaciones de actividad física son de 150 minutos semanales en AF con intensidad moderada o 75 minutos con intensidad vigorosa (Garber et al, 2011).…”

The cut-off values of handgrip strength and lean mass index for sarcopenia among patients on peritoneal dialysis

“…the lower 20th percentile [ 3 ] or 2–2.5 standard deviation (SD) [ 2 , 18 ] below the mean value in the general population, and rarely been verified from the prognostic perspective. Several studies performed in dialysis patients have used the cut-off values recommended by these guidelines to report the prevalence of sarcopenia, 11–41% [ 16 , 19 – 22 ], and indicated close associations between sarcopenia and hospitalization [ 19 ], cardiovascular disease (CVD) [ 23 , 24 ] and mortality [ 19 , 25 ]. These data implicated the importance of screening sarcopenia but did not evaluate the appropriateness of these cut-off values.…”