Study finds link between hand grip strength, malnutrition in patients on hemodialysis
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Researchers from Turkey have identified a link between reduced muscle mass, as measured by hand grip strength, and malnutrition in patients receiving maintenance hemodialysis.
This finding led Hasan Bakkal, MD, of the Kayseri City Training and Research Hospital, and colleagues to recommend clinicians monitor hand grip strength (HGS) to better assess nutritional status in this patient population.
According to the researchers, protein-energy wasting is a condition that occurs in approximately 23% to 76% of patients on hemodialysis.
“In [hemodialysis] HD patients with [protein-energy wasting] PEW, malnutrition and inflammation are the most prominent determinants of mortality,” they wrote. “Therefore, it is important both to diagnose this condition early and to predict the outcomes.”
Contending that reduced muscle mass is one of the most valid ways to diagnose PEW, Bakkal and colleagues included 132 patients who had been on hemodialysis for at least 6 months, determining HGS (measured by hand dynamometer) and evaluating malnutrition (using the malnutrition-inflammation score). Comorbidities were also ranked using the Charlson Comorbidity Index (CCI).
Researchers noted HGS significantly decreased as age increased and HGS was significantly lower in patients with diabetes.
Results showed HGS decreased as malnutrition-inflammation and CCI scores increased. However, after conducting a multiple regression analysis, the researchers found that only MIS score had a significant impact on HGS.
Bakkal and colleagues argued it is important to evaluate HGS because it is a product of age and appears to convey health status in the form of malnutrition and comorbidities.
“These findings indicate that HGS measurement is a noninvasive, inexpensive, objective bedside measurement that can be used in understanding the nutritional status and clinical follow-up of HD patients,” they concluded.
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