Hand grip strength measurement in haemodialysis patients: before or after the session?

Delanaye, Pierre; Quinonez, Kevin; Buckinx, Fanny; Krzesinski, Jean-Marie; Bruyère, Olivier

doi:10.1093/ckj/sfx139

Cited by 23 publications

(17 citation statements)

References 29 publications

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“…Research suggests the HD session can have a negative impact on grip strength. 37,38 Further research looking at HGS prior to or not on HD days would be beneficial to add to the literature on this debate.…”

Section: Discussionmentioning

confidence: 99%

Estimating the Prevalence of Muscle Wasting, Weakness, and Sarcopenia in Hemodialysis Patients

Slee

McKeaveney²,

Adamson³

et al. 2020

Journal of Renal Nutrition

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Haemodialysis (HD) patients suffer from nutritional problems, which include muscle wasting, weakness, and cachexia, and are associated with poor clinical outcomes. The European Working Group for Sarcopenia in Older People (EWGSOP) and Foundations for the National Institute of Health (FNIH) have developed criteria for the assessment of sarcopenia, including the use of non-invasive techniques such as Bioelectrical Impedance Analysis (BIA), anthropometry, and Hand Grip Strength (HGS) dynamometry. This study investigated the prevalence of muscle wasting, weakness, and sarcopenia using the EWGSOP and FNIH criteria. BIA was performed in 24 females (f) and 63 males (m) in the post-dialysis period. Total skeletal muscle mass (TSMM) and appendicular skeletal muscle mass (ASMM) were estimated and index values (i.e., muscle mass divided by height 2 [kg/m 2 ]) were calculated (Total Skeletal Muscle Index (TSMI) and Appendicular Skeletal Muscle Index (ASMI)). Mid-arm circumference and triceps skin-fold thickness were measured and mid-upper arm muscle circumference (MUAMC) calculated. HGS was measured using a standard protocol and Jamar dynamometer. Suggested cut-points for low muscle mass and HGS were utilized from EWGSOP and FNIH criteria, with prevalence estimated, including sarcopenia. The prevalence varied depending on methodology: low TSMI (moderate and severe sarcopenia combined) was 55% for whole group: 21% (f) and 68% (m). Low ASMI was 32% for whole group: 25% (f) and 35% (m). Low MUAMC was 25% for whole group: 0% (f) and 30% (m). ASMI highly correlated with body mass index (BMI) (r = 0.78, P < .001) and MUAMC (r = 0.68, P < .001). Muscle weakness was high regardless of cut-points used (50-71% (f); 60-79% (m)). Internationally, this is the first study comparing measures of muscle mass (TSMM and ASMM by BIA and MUAMC) and muscle strength (HGS) using this specific methodology in a haemodialysis population. Future work is required to confirm findings.

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Section: Discussionmentioning

confidence: 99%

Estimating the Prevalence of Muscle Wasting, Weakness, and Sarcopenia in Hemodialysis Patients

Slee

McKeaveney²,

Adamson³

et al. 2020

Journal of Renal Nutrition

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“…Briefly, the median age of the total studied population was 71 [58-81] years, 60% of the population were men, and 42% of patient had diabetes. The median HGS was 20 [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]…”

Section: Resultsmentioning

confidence: 99%

“…HGS was measured in dominant arms on a dialysis day but before connection to the dialysis machine. 17 In the two Li ege cohorts, measurements were performed in triplicates, with an interval of 5 seconds between measurements, and the higher value was kept for further analysis. 18 The same Jamar dynamometer (JamarÒ Hydraulic Hand Dynamometer, Patterson Medical, Warrenville, IL) with a precision of 0.5 kg was used for all measurements in Li ege1 and Li ege2.…”

Section: Handgrip Strength Measurementmentioning

confidence: 99%

Myostatin and Insulin-Like Growth Factor 1 Are Biomarkers of Muscle Strength, Muscle Mass, and Mortality in Patients on Hemodialysis

Delanaye

Bataille

Quinonez

et al. 2019

Journal of Renal Nutrition

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Objective: Muscle strength is frequently altered in hemodialysis patients. In the present work, five potential muscle biomarkers have been studied in their ability to assess muscular strength, muscular mass and to predict mortality of hemodialysis patients: activin-A, procollagen III N-terminal peptide, follistatin, myostatin and insulin-like growth factor-1 (IGF-1). Design and methods: Three independent cohorts of prevalent hemodialysis patients (2 from Li ege, Belgium and 1 from Marseille, France) were considered in this observational prospective study. The biomarkers were first measured in the Liege1 cohort. Two of them, myostatin and IGF-1, were then assessed in the whole population of patients (Liege1, Liege2 and Marseille). Muscle strength was assessed with handgrip strength (HGS) and muscle mass with bioimpedance analysis. One-year mortality predictive value of biomarkers was also studied in the Li ege1 and Marseille cohorts. Results: In the Li ege1 cohort (n567), HGS was only associated with concentrations of myostatin and IGF-1. These associations were confirmed in the whole population of 204 patients (r50.37, P,0.001 and r50.46, P,0.001, respectively) and remained significant (P,0.05) in multivariable models. The association between muscle mass and concentrations of myostatin and IGF-1were also significant. The ability of myostatin, IGF-1 and serum creatinine to detect a low HGS compared by Receiver Operating Characteristic curves analysis were not significantly different. Both myostatin and IGF-1 had a significant and comparable area under the curve to predict oneyear mortality: 0.73 (95% CI: 0.64 to 0.83) and 0.72 (95% CI: 0.61 to 0.82), respectively. Conclusion: Our results suggest that myostatin and IGF-1 are two biomarkers of interest to assess muscle status of dialysis patients. Both biomarkers are associated with HGS, muscular mass, and one-year mortality.

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“…Moreover, there are also racial differences in muscle mass and strength and different populations should have their own HGS cutoff values to define weakness. In patients undergoing MHD, dialysis therapy may lead to hypotension and a poor general condition, negatively affecting HGS measurement after the dialysis session (23,24). Therefore, it should theoretically be performed before dialysis sessions.…”

Section: Discussionmentioning

confidence: 99%

Handgrip Strength and Mortality in Maintenance Hemodialysis Patients

Tian¹,

Zha²,

Li³

et al. 2019

Iran Red Crescent Med J

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Background: Muscle strength assessment is a convenient clinical test that has shown to correlate with the nutritional status of dialysis patients. Articles written in English to investigate the association between Handgrip Strength (HGS) and mortality in Maintenance Hemodialysis (MHD) patients are mainly from Brazil and several other non-Asian countries. Objectives: This study aimed to examine the association of HGS with all-cause mortality in Chinese MHD patients. Methods: The current multicenter observational longitudinal study enrolled MHD patients from June 2015 to June 2016. The study setting was seven dialysis centers of tertiary general hospitals in Guizhou province, China. Patients were followed up until June 2018. The ROC curves were plotted to seek the best cutoffs for HGS to predict mortality in men and women. Survival analysis was done using the Kaplan-Meier survival curve and the Cox proportional hazard model. Results: We enrolled 857 MHD patients and followed up for 24.9 ± 10.2 months. During the follow-up, 204 (23.8%) patients died, 39 (4.6%) received renal transplantation, 18 (2.1%) switched to peritoneal dialysis, and 118 (11.7%) were transferred to nonparticipating dialysis units. The cutoff value of HGS to predict all-cause mortality was 12.4 kg for women and 25 kg for men. Utilizing the cutoffs to fit the survival curve of Kaplan-Meier, the correlation of HGS with mortality was verified for both genders. After adjustment for demographic and biochemical variables, HGS remained an independent predictor of all-cause mortality. Conclusions: Handgrip strength was strongly associated with all-cause mortality in patients receiving MHD. The cutoff values to predict all-cause mortality were 12.4 kg for women and 25 kg for men. Handgrip strength may be incorporated into clinical practice for assessing functional status and predicting prognosis in MHD patients.

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Hand grip strength measurement in haemodialysis patients: before or after the session?

Cited by 23 publications

References 29 publications

Estimating the Prevalence of Muscle Wasting, Weakness, and Sarcopenia in Hemodialysis Patients

Estimating the Prevalence of Muscle Wasting, Weakness, and Sarcopenia in Hemodialysis Patients

Myostatin and Insulin-Like Growth Factor 1 Are Biomarkers of Muscle Strength, Muscle Mass, and Mortality in Patients on Hemodialysis

Handgrip Strength and Mortality in Maintenance Hemodialysis Patients

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