Handgrip strength is an independent predictor of all-cause mortality in maintenance dialysis patients

Summary Background & Aims Muscle wasting is associated with mortality in dialysis patients. The measurement of muscle mass has some limitations, while muscle strength assessment is simple, safe and allows the recognition of patients at risk of progressing to poor outcomes related to malnutrition...

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Veröffentlicht in:Clinical nutrition (Edinburgh, Scotland) Scotland), 2016-12, Vol.35 (6), p.1429-1433
Hauptverfasser: Vogt, Barbara Perez, RD, MSc, Costa Borges, Mariana Clementoni, RD, Regina de Goés, Cassiana, RD, MSc, Teixeira Caramori, Jacqueline Costa, MD, PhD
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container_end_page 1433
container_issue 6
container_start_page 1429
container_title Clinical nutrition (Edinburgh, Scotland)
container_volume 35
creator Vogt, Barbara Perez, RD, MSc
Costa Borges, Mariana Clementoni, RD
Regina de Goés, Cassiana, RD, MSc
Teixeira Caramori, Jacqueline Costa, MD, PhD
description Summary Background & Aims Muscle wasting is associated with mortality in dialysis patients. The measurement of muscle mass has some limitations, while muscle strength assessment is simple, safe and allows the recognition of patients at risk of progressing to poor outcomes related to malnutrition. The aim of this study is verify if handgrip strength (HGS) is associated with all-cause mortality in patients in maintenance haemodialysis (HD) and peritoneal dialysis (PD). Methods This was an observational retrospective cohort study which included all patients in maintenance HD and PD from July 2012 to October 2014. Patients were followed-up until June 2015. Results Two-hundred sixty five patients were enrolled (218 HD and 47 PD) and they were followed for 13.4 ± 7.9 months. During the follow-up period, 53 patients (20%) have died, 36 patients (13.6%) have undergone renal transplantation, 13 patients (4.9%) have switched off dialysis method and 5 patients (1.9%) have transferred to another facility. The cut-off of HGS able to predict mortality was 22.5 kg for men and 7 kg for women. Using this cut-off to fit the Kaplan-Meier survival curve, the association of HGS with all-cause mortality for both genders was confirmed. Finally, in the multivariate analysis adjusted for demographic, clinical and nutritional variables, HGS remained the only significant predictor of mortality, independent of dialysis modality. Conclusions HGS cut-offs that predict mortality were 22.5 kg for men and 7 kg for women. HGS was associated with mortality independent of dialysis modality.
doi_str_mv 10.1016/j.clnu.2016.03.020
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The measurement of muscle mass has some limitations, while muscle strength assessment is simple, safe and allows the recognition of patients at risk of progressing to poor outcomes related to malnutrition. The aim of this study is verify if handgrip strength (HGS) is associated with all-cause mortality in patients in maintenance haemodialysis (HD) and peritoneal dialysis (PD). Methods This was an observational retrospective cohort study which included all patients in maintenance HD and PD from July 2012 to October 2014. Patients were followed-up until June 2015. Results Two-hundred sixty five patients were enrolled (218 HD and 47 PD) and they were followed for 13.4 ± 7.9 months. During the follow-up period, 53 patients (20%) have died, 36 patients (13.6%) have undergone renal transplantation, 13 patients (4.9%) have switched off dialysis method and 5 patients (1.9%) have transferred to another facility. The cut-off of HGS able to predict mortality was 22.5 kg for men and 7 kg for women. Using this cut-off to fit the Kaplan-Meier survival curve, the association of HGS with all-cause mortality for both genders was confirmed. Finally, in the multivariate analysis adjusted for demographic, clinical and nutritional variables, HGS remained the only significant predictor of mortality, independent of dialysis modality. Conclusions HGS cut-offs that predict mortality were 22.5 kg for men and 7 kg for women. HGS was associated with mortality independent of dialysis modality.</description><identifier>ISSN: 0261-5614</identifier><identifier>EISSN: 1532-1983</identifier><identifier>DOI: 10.1016/j.clnu.2016.03.020</identifier><identifier>PMID: 27083497</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Dialysis ; Female ; Follow-Up Studies ; Gastroenterology and Hepatology ; Hand Strength ; Handgrip strength ; Humans ; Kaplan-Meier Estimate ; Kidney Failure, Chronic - therapy ; Kidney Transplantation ; Male ; Middle Aged ; Mortality ; Multivariate Analysis ; Nutrition Assessment ; Nutritional assessment ; Nutritional Status ; Peritoneal Dialysis ; Proportional Hazards Models ; Renal Dialysis ; Retrospective Studies ; Young Adult</subject><ispartof>Clinical nutrition (Edinburgh, Scotland), 2016-12, Vol.35 (6), p.1429-1433</ispartof><rights>2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism</rights><rights>Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. 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The measurement of muscle mass has some limitations, while muscle strength assessment is simple, safe and allows the recognition of patients at risk of progressing to poor outcomes related to malnutrition. The aim of this study is verify if handgrip strength (HGS) is associated with all-cause mortality in patients in maintenance haemodialysis (HD) and peritoneal dialysis (PD). Methods This was an observational retrospective cohort study which included all patients in maintenance HD and PD from July 2012 to October 2014. Patients were followed-up until June 2015. Results Two-hundred sixty five patients were enrolled (218 HD and 47 PD) and they were followed for 13.4 ± 7.9 months. During the follow-up period, 53 patients (20%) have died, 36 patients (13.6%) have undergone renal transplantation, 13 patients (4.9%) have switched off dialysis method and 5 patients (1.9%) have transferred to another facility. The cut-off of HGS able to predict mortality was 22.5 kg for men and 7 kg for women. Using this cut-off to fit the Kaplan-Meier survival curve, the association of HGS with all-cause mortality for both genders was confirmed. Finally, in the multivariate analysis adjusted for demographic, clinical and nutritional variables, HGS remained the only significant predictor of mortality, independent of dialysis modality. Conclusions HGS cut-offs that predict mortality were 22.5 kg for men and 7 kg for women. 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Aims Muscle wasting is associated with mortality in dialysis patients. The measurement of muscle mass has some limitations, while muscle strength assessment is simple, safe and allows the recognition of patients at risk of progressing to poor outcomes related to malnutrition. The aim of this study is verify if handgrip strength (HGS) is associated with all-cause mortality in patients in maintenance haemodialysis (HD) and peritoneal dialysis (PD). Methods This was an observational retrospective cohort study which included all patients in maintenance HD and PD from July 2012 to October 2014. Patients were followed-up until June 2015. Results Two-hundred sixty five patients were enrolled (218 HD and 47 PD) and they were followed for 13.4 ± 7.9 months. During the follow-up period, 53 patients (20%) have died, 36 patients (13.6%) have undergone renal transplantation, 13 patients (4.9%) have switched off dialysis method and 5 patients (1.9%) have transferred to another facility. The cut-off of HGS able to predict mortality was 22.5 kg for men and 7 kg for women. Using this cut-off to fit the Kaplan-Meier survival curve, the association of HGS with all-cause mortality for both genders was confirmed. Finally, in the multivariate analysis adjusted for demographic, clinical and nutritional variables, HGS remained the only significant predictor of mortality, independent of dialysis modality. Conclusions HGS cut-offs that predict mortality were 22.5 kg for men and 7 kg for women. HGS was associated with mortality independent of dialysis modality.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>27083497</pmid><doi>10.1016/j.clnu.2016.03.020</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Adult
Aged
Aged, 80 and over
Dialysis
Female
Follow-Up Studies
Gastroenterology and Hepatology
Hand Strength
Handgrip strength
Humans
Kaplan-Meier Estimate
Kidney Failure, Chronic - therapy
Kidney Transplantation
Male
Middle Aged
Mortality
Multivariate Analysis
Nutrition Assessment
Nutritional assessment
Nutritional Status
Peritoneal Dialysis
Proportional Hazards Models
Renal Dialysis
Retrospective Studies
Young Adult
title Handgrip strength is an independent predictor of all-cause mortality in maintenance dialysis patients
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