Impact of Handgrip Strength on Survival in Hemodialysis Patients

<b>Background</b>: Hemodialysis patients face a high mortality risk, requiring effective clinical assessments. In these patients, muscle wasting due to protein-energy wasting (PEW) leads to increased frailty, which is strongly associated with worse outcomes, including higher mortality. A...

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Main Authors: Kyungho Park, Seongyeop Jeong, Hyerim Park, Eu Jin Lee, Young Rok Ham, Ki Ryang Na, Dae Eun Choi
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/1/75
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author Kyungho Park
Seongyeop Jeong
Hyerim Park
Eu Jin Lee
Young Rok Ham
Ki Ryang Na
Dae Eun Choi
author_facet Kyungho Park
Seongyeop Jeong
Hyerim Park
Eu Jin Lee
Young Rok Ham
Ki Ryang Na
Dae Eun Choi
author_sort Kyungho Park
collection DOAJ
description <b>Background</b>: Hemodialysis patients face a high mortality risk, requiring effective clinical assessments. In these patients, muscle wasting due to protein-energy wasting (PEW) leads to increased frailty, which is strongly associated with worse outcomes, including higher mortality. As muscle mass declines, so does functional capacity, making regular assessment of both muscle mass and function critical for prognostic evaluation. Handgrip strength (HGS) offers a quick and reliable measure of muscle strength and functional capacity. In this study, we focused on the impact of HGS on survival in hemodialysis patients, analyzing its relationship with muscle mass and BMI. <b>Methods</b>: This retrospective cohort study included 408 dialysis patients (221 males, 187 females) who underwent bioimpedance spectroscopy (BIS) and HGS assessments between March 2021 and August 2023. Data collected included BIS profiles, HGS, dialysis status, age, complete blood count, blood chemistry, mortality, and CONUT scores. <b>Results</b>: Cox proportional hazards regression analysis revealed that lean tissue index (LTI) (HR 3.30, 95% CI 1.75–6.19), body mass index (BMI) (HR 2.65, 95% CI 1.17–6.01), and handgrip strength (HGS) (HR 4.22, 95% CI 2.05–8.70) were significant predictors of survival in the overall dialysis patient cohort. Gender-specific analysis showed that in males, both LTI (HR 4.81, 95% CI 1.89–12.23) and HGS (HR 5.45, 95% CI 2.18–13.61) significantly predicted survival. In females, HGS (HR 6.01, 95% CI 2.42–14.94) was a significant predictor, while LTI was also significant (HR 3.22, 95% CI 1.24–8.40, <i>p</i> = 0.017). In the multivariate Cox proportional hazards analysis, which adjusted for age, diabetes mellitus (DM), hypertension (HTN), BMI, fat tissue index (FTI), LTI, serum albumin, C-reactive protein (CRP), and CONUT score, HGS remained a significant predictor of survival in female dialysis patients (HR 2.77, 95% CI 1.00–7.65, <i>p</i> = 0.049). <b>Conclusions</b>: HGS has been identified as an important factor for survival in dialysis patients, particularly in female patients, independent of muscle mass and BMI.
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spelling doaj-art-c869b4be58894e1c87f9ef951e289d292025-01-10T13:16:38ZengMDPI AGDiagnostics2075-44182024-12-011517510.3390/diagnostics15010075Impact of Handgrip Strength on Survival in Hemodialysis PatientsKyungho Park0Seongyeop Jeong1Hyerim Park2Eu Jin Lee3Young Rok Ham4Ki Ryang Na5Dae Eun Choi6Department of Nephrology, Chungnam National University Hospital, Daejeon 35015, Republic of KoreaDepartment of Nephrology, Chungnam National University Hospital, Daejeon 35015, Republic of KoreaDepartment of Medical Science, Medical School, Chungnam National University, Daejeon 35015, Republic of KoreaDepartment of Nephrology, Chungnam National University Hospital, Daejeon 35015, Republic of KoreaDepartment of Nephrology, Chungnam National University Hospital, Daejeon 35015, Republic of KoreaDepartment of Nephrology, Chungnam National University Hospital, Daejeon 35015, Republic of KoreaDepartment of Nephrology, Chungnam National University Hospital, Daejeon 35015, Republic of Korea<b>Background</b>: Hemodialysis patients face a high mortality risk, requiring effective clinical assessments. In these patients, muscle wasting due to protein-energy wasting (PEW) leads to increased frailty, which is strongly associated with worse outcomes, including higher mortality. As muscle mass declines, so does functional capacity, making regular assessment of both muscle mass and function critical for prognostic evaluation. Handgrip strength (HGS) offers a quick and reliable measure of muscle strength and functional capacity. In this study, we focused on the impact of HGS on survival in hemodialysis patients, analyzing its relationship with muscle mass and BMI. <b>Methods</b>: This retrospective cohort study included 408 dialysis patients (221 males, 187 females) who underwent bioimpedance spectroscopy (BIS) and HGS assessments between March 2021 and August 2023. Data collected included BIS profiles, HGS, dialysis status, age, complete blood count, blood chemistry, mortality, and CONUT scores. <b>Results</b>: Cox proportional hazards regression analysis revealed that lean tissue index (LTI) (HR 3.30, 95% CI 1.75–6.19), body mass index (BMI) (HR 2.65, 95% CI 1.17–6.01), and handgrip strength (HGS) (HR 4.22, 95% CI 2.05–8.70) were significant predictors of survival in the overall dialysis patient cohort. Gender-specific analysis showed that in males, both LTI (HR 4.81, 95% CI 1.89–12.23) and HGS (HR 5.45, 95% CI 2.18–13.61) significantly predicted survival. In females, HGS (HR 6.01, 95% CI 2.42–14.94) was a significant predictor, while LTI was also significant (HR 3.22, 95% CI 1.24–8.40, <i>p</i> = 0.017). In the multivariate Cox proportional hazards analysis, which adjusted for age, diabetes mellitus (DM), hypertension (HTN), BMI, fat tissue index (FTI), LTI, serum albumin, C-reactive protein (CRP), and CONUT score, HGS remained a significant predictor of survival in female dialysis patients (HR 2.77, 95% CI 1.00–7.65, <i>p</i> = 0.049). <b>Conclusions</b>: HGS has been identified as an important factor for survival in dialysis patients, particularly in female patients, independent of muscle mass and BMI.https://www.mdpi.com/2075-4418/15/1/75hemodialysishandgrip strengthmuscle massbioimpedance spectroscopysurvival
spellingShingle Kyungho Park
Seongyeop Jeong
Hyerim Park
Eu Jin Lee
Young Rok Ham
Ki Ryang Na
Dae Eun Choi
Impact of Handgrip Strength on Survival in Hemodialysis Patients
Diagnostics
hemodialysis
handgrip strength
muscle mass
bioimpedance spectroscopy
survival
title Impact of Handgrip Strength on Survival in Hemodialysis Patients
title_full Impact of Handgrip Strength on Survival in Hemodialysis Patients
title_fullStr Impact of Handgrip Strength on Survival in Hemodialysis Patients
title_full_unstemmed Impact of Handgrip Strength on Survival in Hemodialysis Patients
title_short Impact of Handgrip Strength on Survival in Hemodialysis Patients
title_sort impact of handgrip strength on survival in hemodialysis patients
topic hemodialysis
handgrip strength
muscle mass
bioimpedance spectroscopy
survival
url https://www.mdpi.com/2075-4418/15/1/75
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AT eujinlee impactofhandgripstrengthonsurvivalinhemodialysispatients
AT youngrokham impactofhandgripstrengthonsurvivalinhemodialysispatients
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