Journal
ANNALS OF NUTRITION AND METABOLISM
Volume 68, Issue 4, Pages 268-275Publisher
KARGER
DOI: 10.1159/000447023
Keywords
Chronic kidney disease; Dialysis; Protein energy wasting; Hand grip strength; Pinch strength; Muscle strength
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Funding
- University College London
- Royal Free Hospital
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Background: Muscle weakness is a risk factor for mortality in haemodialysis (HD) patients; we wished to determine whether measuring the composition of the arm with bioimpedance was associated with arm muscle strength. Methods: We measured pinch strength (PS) and hand grip strength (HGS) in 250 adult HD patients with corresponding post-dialysis multifrequency bioelectrical assessments with segmental body analysis. Results: Mean age 64.0 +/- 15.6, 66% male and 45.6% diabetic. The maximum HGS in the dominant or nonfistula arm was 18.9 +/- 9.2 kg and PS 4.09 +/- 1.96 kg respectively, with a correlation of r = 0.80, p < 0.001. HGS was associated with body cell mass (beta 0.37, p < 0.001) and PS with appendicular muscle mass (beta 0.06, p < 0.001). Both HGS and PS were independently associated with the ratio of extracellular water (ECW) to total body water (TBW); beta -139.5, p = 0.024, beta -44.8, p < 0.001 in the arm. The presence of an arterio-venous fistula increased the ECW/TBW ratio in the arm from 0.383 +/- 0.009 to 0.390 +/- 0.012, p < 0.05. Conclusion: Muscle strength measured by HGS and PS was associated with both markers of whole body and segmental body composition within the arm, particularly ECW/TBW. Bioimpedance measurements and assessment of muscle strength should be measured in the non-fistula arm. (C) 2016 S. Karger AG, Basel
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