Handgrip Strength Index: A Novel Parameter Which Quantifies Clinical Weakness in People on Haemodialysis

Dilloway, Tina; Ashby, Damien; Hickson, Mary; Temple, Ayako; Johansson, Lina

doi:10.1053/j.jrn.2022.08.002

Cited by 2 publications

(1 citation statement)

References 35 publications

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“…HGS could be a valuable tool for assessing frailty and maximum isometric muscle strength related to prognosis in HD patients [ 11 ]. It has also been suggested as a biomarker linked with nutritional decline [ 12 , 13 ] and mortality in HD patients [ 14 , 15 ]. Studies have also found correlations between muscle function and the prediction of CKD complications [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of a Combined Intradialytic Exercise Training Program on Functional Capacity and Body Composition in Kidney Transplant Candidates

Michou

Davioti

Syrakou

et al. 2023

JFMK

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Chronic kidney disease (CKD) leads to gradual muscle mass loss, which is strongly associated with lower functional capacity, which limits a patient’s daily activities. The aim of the present study is to examine the effects of a 4-month intradialytic exercise program on the functional capacity and body composition of kidney transplant (KT) candidates. Twenty-nine male patients on hemodialysis (HD) waiting for a kidney transplant, with a mean age of 53.86 ± 9.56 years old and BMI 27.11 ± 5.55 kg/m2, were randomly assigned into the following two groups: A (nA = 15 HD patients), who followed a 4-month intradialytic exercise program combining aerobic and resistance training, with a supervised, progressively increasing workload, and B (nB = 14 HD patients), who continued to receive usual care. At baseline and the end of the study, the KT candidates underwent a 6-min walking distance (6-MWD), and a 10-repetition sit-to-stand test (10-STS) to access physical function, a handgrip strength (HGS) test to evaluate the muscle strength of the non-fistula hand. Moreover, the bioelectrical impedance analysis (BIA) was performed to assess body composition indices, such as body fat (BF), body fat mass index (BFMI), fat-free mass index (FFMI), body cell mass (BCM), basal metabolic rate (BMR), extracellular water (ECW), intracellular water (ICW), total body water (TBW) and phase angle (PhA). Following the exercise program, group A showed favorable improvements in HGS (from 26.59 ± 9.23 to 28.61 ± 9.58 kg, p < 0.05) and 6-MWD (from 427.07 ± 7.66 to 468.16 ± 11.39 m, p < 0.05). Intergroup results from 6-MWD showed a statistically significant difference (Δp = 0.04), at the end of the study. Moreover, group A results from BIA revealed a significant increase of BMR by 2.4% (p < 0.05), ECW by 3.6% (p = 0.01), ICW by 3.8% (p = 0.01), TBW by 4.1% (p = 0.01), lean mass by 2.7% (p = 0.01), and PhA by 13.3% (p = 0.04), while a reduction in BF by 5.0% (p = 0.01) and BFMI by 6.6% (p = 0.03) was also noticed. At the end of the study, group A showed statistical differences in BMR (Δp = 0.01), BMR/BW (Δp = 0.01), dry lean (Δp = 0.01), and PhA (Δp = 0.03), compared to the group B. Linear regression analysis in group A after training showed positive correlations between HGS and both PhA (r = 0.52, p = 0.04) and FFMI (r = 0.64, p = 0.01), and a strong negative correlation between 6-MWT and BF (r = −0.61, p = 0.01). In conclusion, a 4-month intradialytic exercise program can enhance body composition and some physical parameters in HD patients awaiting kidney transplantation.

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Section: Introductionmentioning

confidence: 99%

Effects of a Combined Intradialytic Exercise Training Program on Functional Capacity and Body Composition in Kidney Transplant Candidates

Michou

Davioti

Syrakou

et al. 2023

JFMK

View full text Add to dashboard Cite

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Hand Grip Strength Index, a Novel Tool in Risk‐Assessing Multi‐Ethnic End‐Stage Kidney Disease Patients Treated by Haemodialysis

Nguyen,

Davenport

2024

J Human Nutrition Diet

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IntroductionIncreasing numbers of elderly co‐morbid patients with end‐stage kidney disease (ESKD) are now offered haemodialysis. Simple, rapid screening tools are required to risk‐assess patients, highlighting those requiring nutritional or other support and advising on prognosis. As such, we assessed a newly introduced tool, the hand grip strength index (HGS index), a comparison of measured to predicted HGS.MethodsWe reviewed ESKD dialysis patients dialysing under the care of an inner‐city tertiary dialysis centre who had contemporaneous HGS measurements, and body composition measured by multifrequency bioelectrical impedance analysis, followed for ≤ 9 years, censoring for transplantation.ResultsResults from 1023 patients, 63.2% male, 48.2% White and 46.5% diabetic, with a dialysis vintage of 21.2 (7.2–61.0) months, were analysed. Mortality was significantly greater for those in the lowest HGS index quartile using Kaplan–Meier analysis (p < 0.001). On multivariable step‐backward Cox regression analysis, mortality was independently significantly associated (p < 0.001) with increasing age (hazard ratio [HR] 1.04 95% confidence interval (CI) [1.029–1.045]), higher co‐morbidity score (HR 1.24 [1.142–1.347]) and post‐dialysis extracellular water/total body water ratio (HR 1.15 [1.089–1.219]) and lower HGS index (HR −0.76 [0.991–0.998]), whereas sarcopenia and frailty were not retained in the model.ConclusionIncreasing numbers of elderly co‐morbid patients are being treated with dialysis, so simple screening tools are required to advise on prognosis and highlight patients who may need additional support, including nutrition. We found the HGS index to have prognostic value, along with the traditional risk factors of patient age and co‐morbidity.

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Handgrip Strength Index: A Novel Parameter Which Quantifies Clinical Weakness in People on Haemodialysis

Cited by 2 publications

References 35 publications

Effects of a Combined Intradialytic Exercise Training Program on Functional Capacity and Body Composition in Kidney Transplant Candidates

Effects of a Combined Intradialytic Exercise Training Program on Functional Capacity and Body Composition in Kidney Transplant Candidates

Hand Grip Strength Index, a Novel Tool in Risk‐Assessing Multi‐Ethnic End‐Stage Kidney Disease Patients Treated by Haemodialysis

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