Skeletal Muscle Loss Is Negatively Associated With Single‐Pool Kt/V and Dialysis Duration in Hemodialysis Patients

Abstract

We evaluated the skeletal muscle loss in hemodialysis (HD) patients by bioelectrical impedance analysis (BIA) and handgrip strength test. Thirty-four HD patients and 16 healthy subjects (control group) were measured for skeletal muscle mass normalized as the skeletal muscle mass index (SMI), calculated as skeletal muscle mass (kg)/height (m)(2) using a tetrapolar bioelectrical impedance plethysmograph. Handgrip strength test was also performed using a hand dynamometer in both groups. In HD patients, the associations of SMI and handgrip strength with age, sex, HD conditions, and HD parameters such as body mass index (BMI), single-pool Kt/V (spKt/V), normalized protein catabolic rate (nPCR), creatinine generation rate (CGR) and serum albumin level (Alb) were investigated. SMI of HD patients (4.58 ± 0.95 kg/m(2) ) was significantly lower than that of the control group (5.55 ± 0.80 kg/m(2) , P<0.01). The handgrip strength of HD patients (19.9 ± 7.74 kg) was also significantly lower than that of the control group (33.0 ± 8.94 kg, P<0.01). In HD patients, HD duration was associated with both SMI and handgrip strength. Among HD parameters, spKt/V was negatively associated with both SMI and handgrip strength, BMI and Alb were positively associated with SMI, while nPCR and CGR were associated with neither SMI nor handgrip strength. HD duration independently contributed to skeletal muscle loss and the value of spKt/V may be affected by skeletal muscle loss in HD patients.

Ratio of Dietary n-6/n-3 Polyunsaturated Fatty Acids Independently Related to Muscle Mass Decline in Hemodialysis Patients

“…The Kt/V results in the present study were associated with a loss of ASM in the patients. These results were consistent with those of Morishita et al, who demonstrated that Kt/V was negatively associated with both muscle mass and handgrip strength in 34 HD patients [ 37 ]. It implies that patients with a low muscle mass may require a higher clearance in relation to the volume of urea distribution.…”

“…We found no relationship between dialysis vintage and muscle mass among the patients, even though a previous study revealed that the loss of SMM was negatively associated with dialysis vintage [ 37 ]. The inconsistency in the results of the relationship between dialysis vintage and muscle mass can be explained as follows: the HD patients in our study (i) were relatively young (61.4 ± 10.4 years versus 66.9 ± 9.6 years), (ii) had a relatively short dialysis vintage (5.4 ± 5.3 years versus 6.3 ± 4.7 years), and (iii) had a high SMM index, analyzed using a similar BIA equipment (9.1 ± 1.4 kg/m 2 versus 4.6 ± 1.0 kg/m 2 ).…”

Strategies to improve physical activity by exercise training in patients with chronic kidney disease

“…30 We previously reported that skeletal muscle mass and muscle strength decreased in accordance with duration on hemodialysis, even after adjustment for age and sex. 31 We also reported that physical activity is positively associated with muscle mass in hemodialysis patients. 32 A questionnaire survey of exercise habits in 2,264 hemodialysis and peritoneal dialysis patients found that 795 (35.1%) of these patients exercised little or not at all.…”

Sarcopenia and Physical Inactivity in Patients With Chronic Kidney Disease

“…We previously reported that sarcopenia progressed in accordance with duration on hemodialysis even after adjustment for age and sex ( 21 ). Sarcopenia is a strong predictor of mortality in hemodialysis patients as well as in CKD patients at the pre-dialysis stage ( 14 - 19 ).…”