Handgrip strength and its dialysis determinants in hemodialysis patients

Objective: To evaluate muscle function (MF) of patients on hemodialysis (HD) and to investigate the dialysis determinants of maximal voluntary handgrip strength (HGS). Methods: Forty-three patients on HD (25 men, six diabetics, 54.5 +/- 12.2 y of age, 62.2 +/- 51.4 mo on dialysis) were studied. HGS was measured three times with a mechanical dynamometer (Jamar) before and after HD sessions on the non-fistula side and the highest value was used for analysis. HGS values lower than the 10th percentile of an age-, gender-, and region-specific reference were considered MF loss. Biochemical and dialysis variables (ultrafiltration, interdialytic body weight gain, urea clearance, urea before and after HD, systolic and diastolic blood pressures before and after HD, and difference in systolic and diastolic blood pressures) were also examined. Results: The HGS values before and after HD values were significantly higher in men but were not statistically different before and after the HD sessions (29.8 +/- 10.3 and 30.2 +/- 9.9 kg for men, 14.1 +/- 7.0 and 14.5 +/- 6.3 kg for women). MF loss was observed in 24 patients (55.8%), 12 women and 12 men. Dialysis variables were not different between patients with and without MF loss and did not correlate with HGS measured before or after an HD session. Conclusions: Patients using HD presented a high prevalence of MF loss as assessed by HGS, and it was not influenced by dialysis variables. HGS may be used as a reliable nutritional marker in HD, measured before or after HD sessions. (C) 2011 Elsevier Inc. All rights reserved.